Clin Mol Hepatol.  2016 Jun;22(2):267-271. 10.3350/cmh.2015.0017.

Bone marrow metastasis presenting as bicytopenia originating from hepatocellular carcinoma

• Hong YM
• Yoon KT
• Cho M
• Kang DH
• Kim HW
• Choi CW
• Park SB
• Heo J
• Woo HY
• Lim W
• Bakhtiar UI Islam SM

• KMID: 2373123
• DOI: http://doi.org/10.3350/cmh.2015.0017

Abstract

The bone is a common site for metastasis in hepatocellular carcinoma (HCC). However, bone marrow metastasis from HCC is rarely reported, and its frequency is unclear. Here we report a rare case of bone marrow metastasis that presented as bicytopenia originating from HCC without bone metastasis. A 58-year-old man was admitted for investigation of a liver mass with extensive lymph node enlargement that was detected when examining his general weakness and weight loss. Laboratory findings revealed anemia, thrombocytopenia, mild elevated liver enzymes, normal prothrombin time percentage and high levels of tumor markers (α-fetoprotein and des-γ-carboxyprothrombin). Abdominal computed tomography showed multiple enhanced masses in the liver and multiple enlarged lymph nodes in the abdomen. A bone marrow biopsy revealed only a few normal hematopoietic cells and abundant tumor cells. Despite its rarity, bone marrow metastasis should always be suspected in HCC patients even if accompanied by cirrhosis.

Keyword

Carcinoma; Hepatocellular; Bone marrow; Metastasis

MeSH Terms

Biomarkers/analysis
Bone Marrow/*pathology
Carcinoma, Hepatocellular/*diagnosis
Humans
Liver Neoplasms/*diagnosis
Male
Middle Aged
Neoplasm Metastasis
Positron Emission Tomography Computed Tomography
Protein Precursors/analysis
Prothrombin/analysis
Thrombocytopenia/diagnosis
Tomography, X-Ray Computed
alpha-Fetoproteins/analysis
Biomarkers
Protein Precursors
alpha-Fetoproteins
Prothrombin