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A 45-year-old female with hepatocellular carcinoma (HCC) was admitted to our hospital for further examination of liver dysfunction, and by abdominal ultrasonography a hypoechoic mass was seen in S6, and the tumor measured about 5.1 x 3.7 cm in diameter. Upon admission, the CEA in the serum was elevated to 133 ng/ml. On laparotomy, a cirrhotic liver with massive HCC was found. At the time of operation, metastatic hepatic tumor was observed on the surface of the liver. Right hepatectomy was carried out and the histological diagnosis was HCC. Sixteen months later, multiple metastatic bone tumors were detected in the skull, thoracic vertebrae and ribs by bone scintigraphy. Neither primary lesions nor metastatic liver tumors were found in the patient by either computed tomography (CT) or magnetic resonance imaging (MRI). She died 15 months after admission for HCC. The main cause of death in this patient was metastatic bone tumor and diffuse pleural dissemination. The CEA level in the serum was elevated as the tumor grew and the patient died. We therefore suggest that not only the primary lesion, but also the metastatic liver tumor should be examined in order to establish a diagnosis for any tumor with metastasis.Dairy Queen Opens Up With New Food For Thought And Shake!
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