Surgical management of coincidental metastases to upper cervical spine and skull from hepatocellular carcinoma: A case report

Hiroshi Uei, Yasuaki Tokuhashi, Masafumi Maseda, Masahiro Nakahashi, Hirokatsu Sawada, Koji Matsumoto, Yukihiro Miyakata, Hirotoki Soma

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Metastases to the skull or upper cervical spine from hepatocellular carcinoma (HCC) are very rare. We herein report a unique case of two-site surgery for both skull and upper cervical spine metastases from HCC. The patient was a 64-year-old man with cervical pain. Computed tomography (CT) revealed osteolytic change related to metastatic cervical spine and occipital bone tumors. Two-stage surgery involving posterior occipitocervical fusion and occipital bone tumor resection was performed. The patient’s pain decreased in severity, and postoperative radiotherapy and chemotherapy could be conducted. The postoperative course was favorable, and the patient exhibited improvement in his activities of daily living. Neither cervical spine X-ray examination nor CT showed any instrumentation failure, such as screw loosening, before the patient died of liver failure 13 months after surgery. Patients with both skull and upper cervical spine metastases from liver cancer may have a markedly unfavorable prognosis. Even in these patients, however, surgery as an aggressive palliative treatment may prolong the survival period or maintain the quality of life as long as the patient’s general condition permits.

Original languageEnglish
Pages (from-to)4852-4859
Number of pages8
JournalJournal of International Medical Research
Volume46
Issue number11
DOIs
Publication statusPublished - Nov 2018

Keywords

  • Hepatocellular carcinoma
  • Metastatic spinal tumor
  • Palliative treatment
  • Posterior occipitocervical fusion
  • Skull metastasis
  • Upper cervical spine

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