The online version of this article (doi:10.1186/1477-7819-10-98) contains supplementary material, which is available to authorized users.
The authors declare they have no competing interests. The authors have no conflict of interest to disclose which may have biased their work. The authors declare that they did not receive any funding for this work.
LZ operated on the patient, collected the majority of relevant clinical data and drafted the manuscript. CZ was involved in the collection of data and helped significantly with the writing of the manuscript. SJ carried out the histological examination of the resected specimen, including immunohistochemistry, and helped with the writing of the manuscript. JTS researched the literature for this case and contributed significantly with tables and relevant intellectual comments on the manuscript. CMH helped significantly with the writing of the manuscript and contributed an important interdisciplinary viewpoint that helped substantially improve the intellectual content of the manuscript. MW participated in the design of the report and helped to improve the intellectual content of the manuscript. JK provided relevant surgical experience and advice and helped to improve the intellectual content of the manuscript. HS had the idea to write this case report, participated significantly in its design and coordination and helped to improve the intellectual content of the manuscript. All authors read and approved the final manuscript.
Cases with subcutaneous metastasis of differentiated hepatocellular carcinoma to the abdominal wall without prior seeding as a consequence of local interventions with a negative or normal alpha-fetoprotein level in the serum are extremely rare.
This is the first report of a case with AFP-negative, differentiated hepatocellular carcinoma metastasis to the abdominal wall within a pre-existing subcutaneous lipoma since childhood after antiandrogen therapy with leuprorelin and buserelin acetate for prostate cancer without seeding.
Clinical features including histology, immunohistochemistry, clinical course and surgical approach are presented.
Histological examination revealed a hepatocellular carcinoma with a trabecular and pseudoglandular growth pattern with moderately atypical hepatocytes with multifocal bile formation within a lipoma. The postoperative course of abdominal wall reconstruction with a monocryl-prolene mesh and a local flap after potentially curative resection was uncomplicated.
It may be that previous antiandrogen treatment for prostate carcinoma contributed to the fact that our patient developed alpha-fetoprotein-negative and androgen receptor-negative subcutaneous abdominal wall metastasis within a pre-existing lipoma since childhood.
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- Haematogenous abdominal wall metastasis of differentiated, alpha-fetoprotein-negative hepatocellular carcinoma after previous antiandrogen therapy within a site of lipoma manifestation since childhood
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