Muscular Metastasis of Hepatocellular Carcinoma: Case Report and Literature Review

• Published in: Internal Medicine Vol. 61; no. 2; pp. 189 - 196
• Main Authors: Nakayama, Akihiro, Arai, Jun, Otoyama, Yumi, Sugiura, Ikuya, Nakajima, Yoko, Kajiwara, Atsushi, Ichikawa, Yuki, Uozumi, Shojiro, Shimozuma, Yuu, Uchikoshi, Manabu, Sakaki, Masashi, Tazawa, Sakiko, Shiozawa, Eisuke, Yamochi, Toshiko, Takimoto, Masafumi, Yoshida, Hitoshi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15-01-2022; Japan Science and Technology Agency
• Subjects: Aged; Autopsy; Carcinoma, Hepatocellular - diagnostic imaging; Case Report; Case reports; Contrast Media; contrast-enhanced ultrasonography; Hepatocellular carcinoma; Humans; Image Enhancement; Internal medicine; Literature reviews; Liver cancer; Liver Neoplasms - diagnostic imaging; Male; Metastases; Metastasis; moderately differentiated; muscular metastasis; Skeletal muscle; teres major muscle; Tumors; Ultrasonography; teres major muscle; moderately differentiated; contrast-enhanced ultrasonography; muscular metastasis; hepatocellular carcinoma
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.7200-21

There are few case reports of hepatocellular carcinoma (HCC) metastasis to the skeletal muscle. A 78-year-old man developed a mass in the right shoulder. Washout of contrast medium during contrast-enhanced ultrasonography (CEUS) in both the primary HCC and the metastatic site was detected. Several nodules were scattered throughout the liver on an autopsy. In addition, the moderately differentiated HCC had metastasized to the right teres major muscle. Rare muscular metastasis should be considered if a hepatic tumor is moderately or poorly differentiated HCC. Early washout during CEUS is consistent with a pathological diagnosis of moderately or poorly differentiated HCC.