Cancer Res Treat.  2007 Sep;39(3):104-108.

Bone Metastasis from Primary Hepatocellular Carcinoma: Characteristics of Soft Tissue Formation

• Kim S
• Chun M
• Wang H
• Cho S
• Oh YT
• Kang SH
• Yang J

Abstract

PURPOSE: To assess the characteristics of bone metastasis from hepatocellular carcinoma and the radiation field arrangement based on imaging studies.
MATERIALS AND METHODS
Fifty-three patients (84 lesions) with bone metastasis from a primary hepatocellular carcinoma completed palliative radiation therapy. All patients underwent one of following imaging studies prior to the initiation of radiation therapy: a bone scan, computed tomography or magnetic resonance imaging. The median radiation dose was 30 Gy (7~40 Gy). We evaluated retrospectively the presence of soft tissue formation and the adjustment of the radiation field based on the imaging studies.
RESULTS
Soft tissue formation at the site of bony disease was identified from either a CT/MRI scan (41 lesions) or from a symptomatic palpable mass (5 lesions). The adjustment of the radiation field size based on a bone scan was necessary for 31 of 41 soft tissue forming lesions (75.6%), after a review of the CT/MRI scan. The median survival from the initial indication of a hepatoma diagnosis was 8 months (2 to 71 months), with a 2-year survival rate of 38.6%. The median survival from the detection of a bone metastasis was 5 months (1 to 38 months) and the 1-year overall survival rate was 8.7%.
CONCLUSION
It was again identified that bone metastasis from a primary hepatocellular carcinoma is accompanied by soft tissue formation. From this finding, an adjustment of the radiation field size based on imaging studies is required. It is advisable to obtain a CT or MRI scan of suspected bone metastasis for better tumor volume coverage prior to the initiation of radiation therapy.

Keyword

Bone metastasis; hepatocellular carcinoma; soft tissue formation; radiation therapy

MeSH Terms

Carcinoma, Hepatocellular*
Diagnosis
Humans
Magnetic Resonance Imaging
Neoplasm Metastasis*
Retrospective Studies
Survival Rate
Tumor Burden

Figure

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  Fig. 1 (A) The pre-treatment CT scan shows osteolysis of the right iliac wing by soft tissue formation. (B) The mass size decreases 2 months after completion of radiation therapy with persistent bony destruction.

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  Fig. 2 A bone scan (A) and pelvic MRI (B) of a 46-year-old male patient. Note the osteolytic lesion with expansile soft tissue formation on the right iliac bone. (C) The difference of radiation field based on the bone scan and MRI of the pelvis.

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