Abstract

Majed Odeh*, Yana Kogan and Jacob Bejar

ABSTRACT

Hepatocellular carcinoma (HCC) is one of the most common cancers in the world, and is the most common primary hepatic malignancy in adults. Bone metastasis as the initial manifestation of HCC is rare. However, it sometimes may be very serious with significant spinal cord compression. We report a patient with silent cirrhosis due to infection with hepatitis B virus, who presented with upper back pain of four weeks duration as the initial manifestation of HCC, with subsequent development of significant spinal cord compression due to vertebral metastasis. It is concluded that spinal metastasis from HCC should be considered in the differential diagnosis of un-resolving back pain in patients with underlying chronic liver disease, particularly cirrhosis, in order to prevent serious spinal cord compression with early intervention.