Brain and bone metastasis of hepatocellular carcinoma after a liver transplantation – Case report

Abstract

Liver transplantation has improved the disease-free survival of patients with hepatocellular carcinoma, although local tumor recurrence, and less often extra hepatic metastasis are a possible outcome. We report a case of nervous system metastasis from hepatocarcinoma after liver transplantation. The patient was a sixty-four year old male with cirrhosis due to alcoholic liver disease who underwent a liver transplantation in March 2001. Histological sections of the removed liver have shown well-differentiated hepatocellular carcinoma in II and III hepatic segments. Four months after transplantation, the patient showed repeated pleural effusions and bone pain. Computerized tomography and ultrasound indicated lesions of focal tumor hepatic segments III and IV, and retroperitoneal adenomegaly, and rib and femur metastasis. The patient went into a state of mental confusion, and cranium CT showed brain metastasis in the left parietal lobe. He died in November 2001. The global survival was 8 months with a 6-month tumor-free survival. We reported this case due to the uncommon extrahepatic metastases.