From the Guidelines
Hepatocellular carcinoma (HCC) most commonly metastasizes to the lung, adrenal glands, peritoneum, and bone. According to the most recent guidelines, common sites of HCC metastasis include these organs 1. The metastatic pattern of HCC is influenced by the rich vascular supply of the liver and the tendency of HCC cells to invade blood vessels, facilitating hematogenous spread.
Key Metastatic Sites
- Lung: a common site of distant metastasis
- Adrenal glands: affected in a significant proportion of cases with extrahepatic disease
- Peritoneum: a potential site of metastasis, particularly in cases with advanced disease
- Bone: metastases can occur, particularly in the vertebrae, ribs, sternum, and pelvis, causing significant pain and potential pathological fractures The presence of extrahepatic disease significantly impacts prognosis and therapeutic options for patients with HCC, highlighting the importance of early detection and proper staging 1.
Clinical Implications
- Early detection of metastatic sites is crucial for proper staging and treatment planning
- The presence of extrahepatic disease significantly impacts prognosis and therapeutic options for patients with HCC
- A multidisciplinary team approach is essential for evaluating patients with HCC and developing an effective treatment plan 1.
From the Research
Metastasis of Hepatocellular Carcinoma (HCC)
Hepatocellular carcinoma (HCC) is known to metastasize to various sites outside the liver. The most common sites of metastasis include:
- Lungs 2, 3, 4, 5, 6
- Lymph nodes 2, 3, 4, 5, 6
- Bones 2, 3, 4, 5, 6
- Adrenal glands 2, 3, 6
- Kidneys 2, 6
- Portal vein 4
- Portal lymph nodes 4
- Intra-abdominal lymph nodes 4
- Orbital region 4
- Soft tissue 6
- Rib 6
- Maxillary sinus 2
- Retrobulbar region 2
Rare Sites of Metastasis
While the above-mentioned sites are the most common, HCC can also metastasize to rare sites, such as:
Prognosis and Treatment
The prognosis for patients with extrahepatic metastasis of HCC is generally poor 2, 3, 4, 5, 6. Treatment options may include chemotherapy, surgical resection, and targeted therapy 2, 5, 6. However, the main aim of treatment is often palliation and symptom management 2.