Ann Hepatobiliary Pancreat Surg.  2020 Feb;24(1):68-71. 10.14701/ahbps.2020.24.1.68.

Hepatocellular carcinoma metastasis to the buccal mucosa masquerading as oral cavity malignancy: Case report of a rare entity

• Nadkarni S
• Patkar S
• Acharya R
• Shah A
• Patel S
• Parray A
• Goel M

• KMID: 2471192
• DOI: http://doi.org/10.14701/ahbps.2020.24.1.68

Abstract

Hepatocellular carcinoma, a disease of the developing world, is known to present with extrahepatic metastases. Most common site being the lungs, it is not uncommon for metastases to present at unusual sites like the rectum, spleen and the diaphragm, among others. Metastases to the oral cavity is rare, with the most common primaries being lung, breast and the kidney. Metastases of a hepatocellular carcinoma to the oral cavity is a rare entity with extremely limited data in literature. We present one such unique case of oral cavity metastases from a hepatocellular carcinoma who presented to the Division of Head and Neck Oncology services of our hospital with a large oral cavity lesion, on subsequent workup of which, a hepatocellular carcinoma was identified. Awareness of this possibility can aid in accurate diagnosis and early management of a condition associated with an advanced stage at presentation and poorer prognosis.

Keyword

Hepatocellular carcinoma; Metastasis; Oral cavity; HepPar 1

MeSH Terms

Breast
Carcinoma, Hepatocellular*
Diagnosis
Diaphragm
Head
Kidney
Lung
Mouth Mucosa*
Mouth*
Neck
Neoplasm Metastasis*
Prognosis
Rectum
Spleen

Figure

• 

  Fig. 1 Clinical photograph of the oral cavity lesion with position and extent.

• 

  Fig. 2 (A) CECT abdomen & pelvis; coronal, sagittal and axial sections showing the liver primary with diaphragm & chest wall abutment. (B) CECT abdomen & pelvis axial section showing the liver primary with diaphragm & chest wall abutment.

• 

  Fig. 3 (A) Histopathology photographs of oral cavity metastatic lesion (magnification 200×). (B) Immunohistochemistry with HepPar 1 (oral cavity metastatic lesion) (magnification 200×). (C) IHC with arginase positivity (oral cavity metastatic lesion) (magnification 200×).

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  Fig. 4 (A) Histopathology photograph of liver lesion biopsy on haematoxylin & eosin stain (magnification of 200×). (B) Immunohistochemistry of liver lesion biopsy with Glypican 3 positivity (magnification of 400×).

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