A case of hepatocellular carcinoma presenting with Jacksonian seizures as initial symptom

Abstract

A 58-year-old man with hepatocellular carcinoma who first presented with Jacksonian seizures and died form progressive intracranial complications is described. Autopsy revealed several small lesions of hepatocellular carcinoma with diffuse dissemination of small secondaries throughout the liver, and metastases to various organs and tissues. The cause of the epileptic attacks was thought to be compression upon the right motor area of the cortex and infiltration by the tumor metastasizing to the calvaria. Judging from the content and maturity of collagen fibers in the involved cerebrum, meninges, calvaria and epicranial aponeurosis, it was assumed that the primary matastasis had occurred to the bone-marrow of the calvaria. The discussion includes a review of the world literature on bone metastasis of hepatocellular carcinoma and statistical analyses of 4, 525 hepatocellular carcinoma cases registered in the Annals of Pathological Autopsy Cases in Japan for 1978, 1979 and 1980.