Radiology, Vol 160, 175-178, Copyright © 1986 by Radiological Society of North America

ARTICLES

Skeletal metastases from hepatoma: frequency, distribution, and radiographic features

JE Kuhlman, EK Fishman, PK Leichner, D Magid, SE Order and SS Siegelman

Over the past 6 years, the authors evaluated 300 patients with hepatoma as part of phase 1 and 2 treatment protocol trials. Analysis of the available clinical data and radiographic studies revealed 22 patients (7.3%) with skeletal metastases demonstrated by radiography, computed tomography (CT), and/or nuclear scintigraphy. The plain film appearance of skeletal metastases from hepatoma was osteolytic in all cases. CT scanning best demonstrated the expansile, destructive nature of these metastases, which were often associated with large, bulky soft-tissue masses. Skeletal metastases from hepatomas demonstrated increased radiotracer uptake on standard bone scans and were gallium avid, similar to the hepatoma itself. In addition, they could be targeted therapeutically with I-131 antiferritin immunoglobulin. The most frequent sites of skeletal metastases were the ribs, spine, femur, pelvis, and humerus. An initial symptom in ten patients was skeletal pain corresponding to the osseous metastases. In five patients, pathologic fractures of the proximal femur or humerus developed and required total hip replacement or open-reduction internal fixation. Patients with long-standing cirrhosis or known hepatocellular carcinoma who also have skeletal symptoms should be evaluated for possible osseous metastases.

This article has been cited by other articles:

				C.-l. Ho, S. Chen, D. W.C. Yeung, and T. K.C. Cheng Dual-Tracer PET/CT Imaging in Evaluation of Metastatic Hepatocellular Carcinoma J. Nucl. Med., June 1, 2007; 48(6): 902 - 909. [Abstract] [Full Text] [PDF]