Solitary Skull Metastasis as Initial Presentation of Hepatocellular Carcinoma: A Rare Case Report and Management Review
- 1Department of Neurosurgery, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India
Abstract
Hepatocellular carcinoma (HCC) rarely metastasizes to the skull, often leading to diagnostic challenges. This case report describes a 64-year-old man presenting with right-sided limb weakness and a scalp mass in the left parietal region. Initial surgery for the scalp swelling was performed without a diagnostic workup, and the lesion recurred with neurological impairment. Imaging revealed a skull lesion eroding the bone and extending intracranially, with a solitary liver lesion identified as the primary tumour. Surgical resection of the skull metastasis was performed, followed by chemotherapy. Histopathology confirmed high-grade HCC metastasis. The patient showed neurological improvement postoperatively. This report highlights the importance of considering skull metastasis in HCC patients presenting with scalp masses and neurological deficits, especially in endemic areas. Early imaging and aggressive multidisciplinary management, including en bloc resection, can improve outcomes despite the aggressive nature of HCC.
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BibTeX
@article{chugh2026solitary,
title = {{Solitary Skull Metastasis as Initial Presentation of Hepatocellular Carcinoma: A Rare Case Report and Management Review}},
author = {Ashish Chugh and Dipti Patil and Prashant Punia and Sarang Gotecha},
journal = {Annals of African Medicine},
year = {2026},
month = jul,
doi = {10.4103/aam.aam_288_26},
url = {https://doi.org/10.4103/aam.aam_288_26},
note = {CC BY-NC-SA 4.0},
}
RIS
TY - JOUR
TI - Solitary Skull Metastasis as Initial Presentation of Hepatocellular Carcinoma: A Rare Case Report and Management Review
AU - Ashish Chugh
AU - Dipti Patil
AU - Prashant Punia
AU - Sarang Gotecha
PY - 2026
DA - 2026/07/03
JO - Annals of African Medicine
DO - 10.4103/aam.aam_288_26
UR - https://doi.org/10.4103/aam.aam_288_26
AB - Hepatocellular carcinoma (HCC) rarely metastasizes to the skull, often leading to diagnostic challenges. This case report describes a 64-year-old man presenting with right-sided limb weakness and a scalp mass in the left parietal region. Initial surgery for the scalp swelling was performed without a diagnostic workup, and the lesion recurred with neurological impairment. Imaging revealed a skull lesion eroding the bone and extending intracranially, with a solitary liver lesion identified as the primary tumour. Surgical resection of the skull metastasis was performed, followed by chemotherapy. Histopathology confirmed high-grade HCC metastasis. The patient showed neurological improvement postoperatively. This report highlights the importance of considering skull metastasis in HCC patients presenting with scalp masses and neurological deficits, especially in endemic areas. Early imaging and aggressive multidisciplinary management, including en bloc resection, can improve outcomes despite the aggressive nature of HCC.
SN - 1596-3519
SN - 0975-5764
ER -