Korean J Otorhinolaryngol-Head Neck Surg.  2017 Jul;60(7):356-359. 10.3342/kjorl-hns.2017.16257.

A Case of Metastatic Hepatocellular Carcinoma Mimicking Acute Cervical Lymphadenitis

• Choi YS
• Bae CH
• Kim YD
• Song SY

• KMID: 2386375
• DOI: http://doi.org/10.3342/kjorl-hns.2017.16257

Abstract

Hepatocellular carcinoma (HCC) is the most common cancer of the liver and the fifth most common cancer worldwide. The sites of extrahepatic metastasis are usually the lungs, adrenal gland, bone and brain via hematogeneous spreads. The lymphatic spread of HCC, mostly occurring at the regional abdominal lymph nodes, is relatively rare. Cervical lymph node metastasis of HCC is a very rare presentation, so that it is easily neglected in the clinic. In some cases, differential diagnosis between cervical lymphadenitis and lymph node metastasis can be challenging due to similar clinical features such as rapidly growing pattern, tenderness, fever and general ache. We report a case of left cervical lymphadenopathy diagnosed as HCC without prior diagnosis of HCC. A core-needle biopsy of left cervical lymphadenopathy demonstrated poorly differentiated unknown primary metastatic cancer. Positron emission tomography-computed tomography revealed the liver as the primary site of metastasis and the pathologic examination of liver biopsy specimen determined it to be HCC.

Keyword

Acute lymphadenitis; Cervical lymph node metastasis; Hepatocellular carcinoma

MeSH Terms

Adrenal Glands
Biopsy
Brain
Carcinoma, Hepatocellular*
Diagnosis
Diagnosis, Differential
Electrons
Fever
Liver
Liver Neoplasms
Lung
Lymph Nodes
Lymphadenitis*
Lymphatic Diseases
Neoplasm Metastasis