Unusual extrahepatic metastatic sites from hepatocellular carcinoma.

The author examined unusual extrahepatic metastatic sites from liver hepatocellular carcinomas (HCCs) in autopsy and surgical files at our laboratory in the last 10 years. In autopsy cases (n=31), extrahepatic metastases were present in 21 cases (68%). The most common metastatic sites were lung (n=18). Unusual extrahepatic metastatic sites in the autopsy series were abdominal regional lymph nodes (n=6), bones (n=5), diaphragma (n=2), pancreas (n=2), gall bladder (n=1), stomach (n=1), colon (n=1), adrenal gland (n=1), pleura (n=1), peritoneum (n=1), cervical lymph nodes (n=1), and shoulder soft tissue (n=1). In surgical cases (n=21), in which extrahepatic tumors were excised, the lung was the most common, and accounted for 16 cases. The unusual extrahepatic metastatic sites in the surgical series were bones (n=2), brain (n=1), skin (n=1), and oral cavity (n=1). Immunohistochemical demonstration of HepPar1 and AFP were recognized in 12 of 12 surgical cases examined and 8 of the 12 surgical cases examined, respectively. Cytokeratin 8 and 18 were expressed in 6 of 6 surgical cases and 7 of 7 surgical cases examined. These data shows that HCC can metastasize in various organs other than the lung, and HepPar1 and AFP were good markers of extrahepatic metastases of these unusual sites of metastatic foci from HCC.