HEPATOCELLULAR-CARCINOMA PRESENTING AS A PANCREATIC HEAD MASS - REPORT OF AN UNUSUAL CASE

Hepatocellular carcinoma (HCC) spreading to the pancreas is rare and, when it does occur, is most often detected as a late finding at autops y. We report the first case of HCC initially presenting as a pancreati c mass. Computed tomography (CT) scan showed a 7-cm mass in the dome o f the liver and a 3-cm pancreatic head mass causing biliary and duoden al obstruction. Palliative surgery was performed to bypass the pancrea tic obstruction. During the operation, fine needle aspiration (FNA) wa s performed on the pancreatic mass. The liver mass was sampled by perc utaneous ultrasound-guided biopsy. Postoperatively, the patient's obst ructive symptoms were relieved. The histologic studies showed that bot h the liver and the pancreatic masses consisted of poorly differentiat ed HCC thar stained positive for cu-fetoprotein. The rarity and the im plications of this presentation are discussed.