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Hepatocellular carcinoma presenting with scalp & oral metastases: A rare presentation
*For correspondence: drmayanktripathi1@gmail.com
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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
A 64 yr old male†, chronic alcoholic, presented to the department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India, in September 2019, with swellings over the right cheek and scalp for four months. A lobulated swelling over the parieto-occipital region (10 × 8 cm) and a submucosal soft tissue mass (10 × 6 cm) involving the right cheek from the zygoma till the lower border of the mandible were seen (Figure A and B). Biopsy of the scalp lesion showed metastatic carcinoma with hepatoid differentiation (Figure C) and showed positivity for AE1/AE3 and Hep Par 1. Contrast-enhanced computed tomographic scan of the abdomen showed arterially enhancing lesion in the segment IVb, V, VI and VII of the liver (Figure D). The patient was found to be hepatitis C positive with high alpha-foetoprotein level of 520 ng/ml. A diagnosis of hepatocellular carcinoma with scalp and oral metastases was made, and the patient was started on tablet sorafenib. He was alive with stable disease at two month follow up.
- (A) Soft tissue swelling over the cheek and scalp. (B) Contrast-enhanced computed tomographic (CECT) image of the cheek swelling (red arrow). (C) Histopathology of the scalp lesion showing malignant cells with hepatoid differentiation (H and E stain, ×40). (D) CECT abdomen image showing liver lesion (red arrow) showing enhancement in arterial phase, also seen is the ascites.
Conflicts of Interest: None.
