Primary manifestation of hepatocellular carcinoma as osteolytic hand metastasis

Osseous metastases to the hand are very rare. Only a single case of osseous metastasis of hepatocellular carcinoma to the hand has been reported in th e literature to date. We report a case of osteolytic metastasis of the righ t first metacarpal as first manifestation of unresectable, alphafetoprotein -negative hepatocellular carcinoma (pT(3), N-x, M-1, UICC stage IVB,Okuda's stage I). The therapy consisted of R-0-resection and hormonal therapy with tamoxifen 2 x 10 mg/d orally. Generally patients with metastatic cancer to the bones of the hand have a very poor prognosis.