Hepatocellular carcinoma (HCC) is an aggressive tumor with poor long-term prognosis. The reported 5-year recurrence rate ranges from 75% to 100%. Therefore, extrahepatic metastasis of HCC is uncommon due to the highly malignant nature of the primary tumor. However, with advances in different treatment modalities for HCC, the incidence of extrahepatic metastasis appears to be increasing. Nevertheless, most recurrences occur relatively early after the initial diagnosis and treatment.
A research article to be published on May 7, 2010 in the World Journal of Gastroenterology addresses this question.
The research team from Hong Kong reported a patient who presented with a renal tumor 12 years after the initial treatment of primary HCC, which turned out to be a solitary recurrence of the initial HCC.
The case illustrated that, in managing patients with a past history of HCC who present with new mass lesions, the diagnosis of extra-hepatic metastasis should always be suspected. Although the final treatment might not be altered, the diagnosis of metastatic HCC would allow better surgical planning and counseling for the patient.