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- Title
Unusual Initial Presentation of Hepatocellular Carcinoma as a Clavicular Head Mass.
- Authors
Gupta, Rohit; Hirsch, Joshua R.; Guhan, Maya; Triska, Jeffrey; Hernaez, Ruben; Taylor, Addison
- Abstract
Background: Hepatocellular carcinoma (HCC) is a common cancer worldwide. Extrahepatic spread is not unusual during HCC disease, but bone metastases at initial presentation are rare. Case Description: We describe a case of HCC presenting with a clavicular head mass and spinal metastases with normal α-fetoprotein (AFP) level and hepatitis C virus infection without cirrhosis. After undergoing bone and liver biopsies, the patient started a 12-week course of sofosbuvir/velpatasvir and bevacizumab/atezolizumab for lifelong therapy with palliative intent. Since 2021, the patient has been receiving a combination of bevacizumab and atezolizumab every 21 days. On this regimen as of March 2023, his osseous metastases were stable and his liver lesions had not enlarged. Conclusions: This case demonstrates a very unusual HCC presentation, the importance of a thorough workup of bone metastasis, and the limited value of AFP for HCC screening, even in disseminated disease.
- Subjects
PROTEUS diseases; ALPHA fetoproteins; BIOPSY; LUNG abscesses; METASTASIS; HEPATITIS C; CIRRHOSIS of the liver; ANTIVIRAL agents; EARLY detection of cancer; HEALTH care teams; COMPUTED tomography; TUMOR markers; PROGRESSION-free survival; CLAVICLE; HEPATOCELLULAR carcinoma; SPINAL tumors; SYMPTOMS
- Publication
Oncology (08909091), 2023, Vol 37, Issue 8, p335
- ISSN
0890-9091
- Publication type
Article
- DOI
10.46883/25921003