Primary manifestation of hepatocellular carcinoma as a cervical mass

Abstract

Metastasis of hepatocellular carcinoma to the head and neck region is unusual and its exact frequency is unknovvn. A 72-year-old male patient presented with a mass on the left side of the neck. Clinical examina- tion showed multiple, painless, immobile lym- phadenopathies in the cervical region. Computed tomography revealed both an irregular mass in the cervical region and hepatomegaly accompanied by a lobulated liver contour. The patient was diagnosed as having hepatocellular carcinoma following an exci- sional biopsy from the cervical mass and fine needle aspiration biopsy from the liver.

Keywords

• Carcinoma, hepatocellular, head and neck neoplasms

Boyunda kitle ile ortaya ç›kan hepatoselüler karsinom

Abstract

Hepatoselüler kanserin baş-boyun bölgesine yayı- lımı çok nadirdir ve sıklığı tam olarak bilinmemek- tedir. Yetmiş iki yaşındaki erkek hasta boynun sol tarafında gelişen kitle nedeniyle kliniğimize baş- vurdu. Klinik muayenede servikal bölgede ağrısız, hareketsiz kitleler halinde çok sayıda lenfadenopa- ti saptandı. Bilgisayarlı tomografide servikal bölge- de düzensiz kitle görüldü, karaciğer lobüle yapıda ve büyüktü. Boyundaki kitleden yapılan eksizyonel biyopsi ve karaciğerden yapılan ince iğne aspiras- yon biyopsisi sonucunda hepatoselüler karsinom tanısı kondu

Keywords

• Karsinom, hepatoselüler, bafl-boyun neoplazileri.

References

1. Yuki K, Hirohashi S, Sakamoto M, Kanai T, Shimosato Y. Growth and spread of hepatocellular carcinoma. A review of 240 consecutive autopsy cases. Cancer 1990;66:2174-9.
2. Simon JB. Hepatic and biliary disorders. In: Berdow R, Fletcher A, editors. The merck manual. Rahway: Merck Research Laboratories; 1992. p. 864-930.
3. Chin A, Liang TS, Borislow AJ. Initial presentation of hepatocellular carcinoma as a mandibular mass: case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86:457-60.
4. Lin DY, Liaw YF, Chu CM, Chang-Chien CS, Wu CS, Chen PC, et al. Hepatocellular carcinoma in noncir- rhotic patients. A laparoscopic study of 92 cases in Taiwan. Cancer 1984;54:1466-8.
5. Maltz C, Lightdale CJ, Winawer SJ. Hepatocellular car- cinoma. New directions in etiology. Am J Gastroenterol 1980;74:361-5.
6. Llanes F, Sanz-Ortega J, Suarez B, Sanz-Esponera J. Hepatocellular carcinomas diagnosed following metastasis to the oral cavity. Report of 2 cases. J Periodontol 1996;67:717-9.
7. Okada H, Kamino Y, Shimo M, Kitamura E, Katoh T, Nishimura H, et al. Metastatic hepatocellular carcino- ma of the maxillary sinus: a rare autopsy case without lung metastasis and a review. Int J Oral Maxillofac Surg 2003;32:97-100.
8. Morishita M, Fukuda J. Hepatocellular carcinoma metastatic to the maxillary incisal gingiva. J Oral Maxillofac Surg 1984;42:812-5.

9. Chen CH, Sheu JC, Huang GT, Lee HS, Yang PM, Tsang YM, et al. Recurrent hepatocellular carcinoma presenting with superior vena cava syndrome. Hepatogastroenterology 2000;47:1117-9.
10. Izquierdo J, Armengot M, Cors R, Perez A, Basterra J. Hepatocarcinoma: metastasis to the nose and paranasal sinuses. Otolaryngol Head Neck Surg 2000;122:932-3.
11. Ramon Ramirez J, Seoane J, Montero J, Esparza Gomez GC, Cerero R. Isolated gingival metastasis from hepa- tocellular carcinoma mimicking a pyogenic granulo- ma. J Clin Periodontol 2003;30:926-9.
12. Sohara N, Takagi H, Yamada T, Ichikawa T, Abe T, Itoh H, et al. Esophageal metastasis of hepatocellular carci- noma. Gastrointest Endosc 2000;51:739-41.
13. Mochimatsu I, Tsukuda M, Furukawa S, Sawaki S. Tumours metastasizing to the head and neck-a report of seven cases. J Laryngol Otol 1993;107:1171-3.
14. Pires FR, Sagarra R, Correa ME, Pereira CM, Vargas PA, Lopes MA. Oral metastasis of a hepatocellular car- cinoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;97:359-68.
15. Kew MC. Virchow-Troisier’s lymph node in hepatocel- lular carcinoma. J Clin Gastroenterol 1991;13:217-9.
16. Barrera-Franco JL, Flores-Flores G, Mosqueda-Taylor A. Mandibular metastasis as the first manifestation of hepatocellular carcinoma: report of a case and review of the literature. J Oral Maxillofac Surg 1993;51:318-21.
17. Mucitelli DR, Zuna RE, Archard HO. Hepatocellular carcinoma presenting as an oral cavity lesion. Oral Surg Oral Med Oral Pathol 1988;66:701-5.
18. Brown NE, O’Brien DA, Megerian CA. Metastatic hepatocellular carcinoma to the temporal bone in a post-liver transplant patient. Otolaryngol Head Neck Surg 2004;130:370-1.
19. Neff BA, Pribitkin EA, Willcox TO Jr. Hepatocellular cancer metastatic to the zygoma: primary resection and immediate reconstruction. Ear Nose Throat J 2002; 81:57-8.
20. Zubler MA, Rivera R, Lane M. Hepatoma presenting as a retro-orbital metastasis. Cancer 1981;48:1883-5.
21. Kanazawa H, Sato K. Gingival metastasis from primary hepatocellular carcinoma: report of a case and review of literature. J Oral Maxillofac Surg 1989; 47:987-90.