A Case of Solitary Splenic Metastasis of Hepatocellular Carcinoma

Abstract

A 60 year-old man, who underwent right lateral hepatic sectionectomy, transcatheter arterial chemoembolization (TACE), and radiofrequency ablation (RFA) for chronic hepatitis C virus-related hepatocellular carcinoma (HCC), was found to have a 35 mm solitary mass in the spleen during abdominal ultrasound and computed tomography (CT) in December 2015. Contrast-enhanced CT and magnetic resonance imaging revealed no viable lesion of HCC in the liver despite increased AFP and PIVKA II, suggesting the splenic tumor was a metastasis of HCC. Splenectomy was performed in January 2016 in order to avoid the risk of rupture and to increase long-term survival. Operative findings revealed no dissemination. Macroscopically, the splenic tumor showed a yellowish expanding growth with a capsule measuring 38×31 mm in diameter that was limited to the splenic parenchyma. Histological and immunochemical examination confirmed splenic metastasis of HCC, negative for lymphatic metastasis of the splenic hilum. We report a rare case of solitary splenic metastasis of HCC.