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CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 183

Hepatocellular carcinoma presenting with scalp & oral metastases: A rare presentation


Department of Surgical Oncology, Tata Memorial Hospital, Mumbai 400 012, Maharashtra, India

Date of Submission20-Nov-2019
Date of Web Publication25-May-2021

Correspondence Address:
Mayank Tripathi
Department of Surgical Oncology, Tata Memorial Hospital, Mumbai 400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_2282_19

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How to cite this article:
Tripathi M, Goel M. Hepatocellular carcinoma presenting with scalp & oral metastases: A rare presentation. Indian J Med Res 2020;152, Suppl S1:183

How to cite this URL:
Tripathi M, Goel M. Hepatocellular carcinoma presenting with scalp & oral metastases: A rare presentation. Indian J Med Res [serial online] 2020 [cited 2021 Aug 4];152, Suppl S1:183. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/183/316810

Patient's consent obtained to publish clinical information and images


A 64 yr old male, chronic alcoholic, presented to the department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India, in September 2019, with swellings over the right cheek and scalp for four months. A lobulated swelling over the parieto-occipital region (10 × 8 cm) and a submucosal soft tissue mass (10 × 6 cm) involving the right cheek from the zygoma till the lower border of the mandible were seen [Figure 1]A and [Figure 1]B. Biopsy of the scalp lesion showed metastatic carcinoma with hepatoid differentiation [Figure 1]C and showed positivity for AE1/AE3 and Hep Par 1. Contrast-enhanced computed tomographic scan of the abdomen showed arterially enhancing lesion in the segment IVb, V, VI and VII of the liver [Figure 1]D. The patient was found to be hepatitis C positive with high alpha-foetoprotein level of 520 ng/ml. A diagnosis of hepatocellular carcinoma with scalp and oral metastases was made, and the patient was started on tablet sorafenib. He was alive with stable disease at two month follow up.
Figure 1: (A) Soft tissue swelling over the cheek and scalp. (B) Contrast-enhanced computed tomographic (CECT) image of the cheek swelling (red arrow). (C) Histopathology of the scalp lesion showing malignant cells with hepatoid differentiation (H and E stain, ×40). (D) CECT abdomen image showing liver lesion (red arrow) showing enhancement in arterial phase, also seen is the ascites.

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Conflicts of interest: None.


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