Fibrolamellar hepatocellular carcinoma with skeletal metastases

Skeletal metastases is relatively rare in hepatocellular carcinoma and acco unts for 4-16% of extrahepatic metastases. The authors report a 13-year-old girl with fibrolamellar hepatocellular carcinoma, who rejected further sys temic chemotherapy following hepatic lobectomy and experienced sternal and vertebral painful metastases nearly 5 years after the operation. The sterna l metastatic lesion was removed surgically, whereas external irradiation wa s delivered to the lumbar vertebral lesion. The patient received no systemi c treatment following metastases and died with widespread disease. Despite metastatic disease, the patient survived 6.5 years following the initial di agnosis.