Surgical removal of a distinct subcutaneous metastasis of multilocular hepatocellular carcinoma 2 months after initial percutaneous ethanol injectiontherapy

Subcutaneous tumor seeding after percutaneous ethanol injection therapy (PE I) for hepatocellular carcinoma is a rarely seen complication. It is report ed due to needle track seeding during PEI after a distance of 6-46 months. Metastatic tumor spread is described subcutaneously, to the chest wall, abd ominal wall and diaphragm. We report the case of a 76-year-old patient with chronic hepatitis B infection and cirrhosis which let to a multilocular he patocellular carcinoma who underwent PEI. This patient developed 2 months a fter primary PEI a subcutaneous tumor formation confined to the right lower chest wall. Surgical tumor resection was performed. The histopathological evaluation confirmed subcutaneous seeding of the preknown hepatocellular ca rcinoma with a maximum of 30 mm in diameter. As a risk of PEI subcutaneous metastasis of the primary tumor should be considered even in early stage of therapy and close follow-up of the patient during treatment is required. S urgical tumor resection to ensure the curative intention of PEI is advisabl e.