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January 1982

Hepatocellular Carcinoma: Manifestation as a Chest Wall Metastasis

Author Affiliations

From the Division of Medical Oncology, Queens Hospital Center, jamaica, NY (Drs Bennett, Kalra, and Cortes); and Department of Medicine, Health Sciences Center, State University of New York at Stony Brook (Dr Cortes).

Arch Dermatol. 1982;118(1):69-70. doi:10.1001/archderm.1982.01650130073030

Hepatoma metastasizes to the lungs, adrenal glands, regional lymph nodes, portal vein, gallbladder, pancreas, bone, hepatic vein, kidney, mediastinum, and, less commonly, the heart, peritoneum, diaphragm, and bone marrow. Skin metastases occur rarely.1 We report herein a case of hepatoma with a chest wall metastasis as the initial physical finding.

Report of a Case  A 77-year-old man was hospitalized for rectal bleeding. The patient also complained of a chestwall mass, anorexia, and a 22.5-kg weight loss during a five-month period. The patient was a heavy smoker and drank large amounts of alcohol. Physical findings included an 8 × 10-cm, soft, nontender, freely movable mass on the right side of the anterior part of the chest wall (Fig 1) and trace edema of the lower extremities.The hemoglobin level was 8.7 g/dL and the WBC count was 18,200/cu mm, with a normal differential cell count. Moderate hypochromia was seen on the peripheral