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January 4, 1971

Hepatoma Metastatic to Rib

Author Affiliations

Lexington. Ky

JAMA. 1971;215(1):120. doi:10.1001/jama.1971.03180140084027

To the Editor.—  The article by Reichback et al (213:2078, 1970) discussed unusual osseous metastases from malignant hepatoma. The authors emphasized the bizarre nature of hepatoma metastases and reported two cases which presented with osseous spread as the initial manifestation. One of these lesions was a pulsatile mass in the right temporal area. The following case report describes another unusual presentation from an osseous metastasis of hepatoma.

Report of a Case.—  A 76-year-old white man presented at the University of Kentucky Medical Center with a chief complaint of pain in the right upper quadrant, nausea and vomiting, and fever of two days duration. He had a several-year history of fatty food intolerance and vague pain in the abdomen. His temperature was 101 F. Physical examination revealed marked tenderness in the right upper quadrant without evidence of a mass. Bowel sounds were decreased and a liver rub was heard over