• Akihiro Nakayama, Jun Arai, Yumi Otoyama, Ikuya Sugiura, Yoko Nakajima, Atsushi Kajiwara, Yuki Ichikawa, Shojiro Uozumi, Yuu Shimozuma, Manabu Uchikoshi, Masashi Sakaki, Sakiko Tazawa, Eisuke Shiozawa, Toshiko Yamochi, Masafumi Takimoto, and Hitoshi Yoshida.
• Department of Medicine, Division of Gastroenterology, Showa University School of Medicine, Japan.
• Intern. Med. 2022 Jan 15; 61 (2): 189-196.

AbstractThere are few case reports of hepatocellular carcinoma (HCC) metastasis to the skeletal muscle. A 78-year-old man developed a mass in the right shoulder. Washout of contrast medium during contrast-enhanced ultrasonography (CEUS) in both the primary HCC and the metastatic site was detected. Several nodules were scattered throughout the liver on an autopsy. In addition, the moderately differentiated HCC had metastasized to the right teres major muscle. Rare muscular metastasis should be considered if a hepatic tumor is moderately or poorly differentiated HCC. Early washout during CEUS is consistent with a pathological diagnosis of moderately or poorly differentiated HCC.

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