Hepatocellular cancer metastatic to the zygoma: primary resection and immediate reconstruction.

Hepatocellular carcinoma is common worldwide but relatively rare in the United States, where only 13,000 new cases are diagnosed each year. Metastasis to osseous structures in the head and neck are extremely rare; when they do occur, most appear as oral cavity masses secondary to mandibular and maxillary involvement. We report the case of an isolated zygomatic metastasis in a patient who had been previously treated for hepatocellular carcinoma with orthotopic liver transplantation. The patient underwent a complete excision of the mass followed by immediate reconstruction of the zygomaxillary buttress and the orbital rim and floor. To our knowledge, only one other case similar to ours has been previously reported; in that instance, the metastatic tumor was not resectable.