Hepatocellular carcinoma revealed par bone metastasis: three cases report

Abstract

Introduction and importance: Bone metastases from hepatocellular carcinoma (HCC) are rare. They are exceptionally revealing. The elective sites are the vertebrae, the ribs, and the sternum. Treatment remains palliative most often, which makes the prognosis very poor. Case presentation: We report three cases of vertebral metastases revealing HCC. Their management consisted of a laparoscopic biopsy followed by decompressive radiotherapy, supportive care in two cases, and sorafenib in one case. Median survival was 3 and 6 months, respectively. These observations allowed us to carry out a review of the literature on this particular clinical entity and to take stock of the therapeutic modalities. Clinical discussion: The discovery of HCC at the stage of bone metastases is rare. The prognosis is bad. The biopsy is justified by the rarity of these metastases. Radiotherapy on metastases improves quality of life without extending survival. Conclusion: Lytic bone lesions on HCC should suggest secondary localizations. Their prognosis remains bleak since the treatment is often only palliative.