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A Journal on Neurosurgery

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Journal of Neurosurgical Sciences 2002 June;46(2):77-80

language: English

Brain metas­ta­ses ­from hepat­o­cel­lu­lar car­ci­no­ma. A ­case ­report

Salvati M. 1, Cimatti M. 2, Frati A. 1, Santoro A. 2, Gagliardi F. M. 1

1 Department of Neurosurgery, IRCCS Neuromed, Pozzilli (IS);
2 Division of Neurotraumatology, Department of Neurological Sciences, University “La Sapienza”, Rome


Brain metas­ta­sis ­from hepat­o­car­cin­o­ma are a decid­ed­ly ­rare occur­rence in coun­tries ­where ­this pathol­o­gy is ­most fre­quent. The ­authors ­describe a ­case of metas­ta­ses ­from hepat­o­cel­lu­lar car­ci­no­ma in a ­patient suf­fer­ing ­from ­post-HBV hepat­ic cir­rho­sis ­with hemor­rhag­ic ­onset. The “­stroke-­like” pres­en­ta­tion of the cere­bral local­iza­tion of the dis­ease can be ­explained by ­both the impor­tant vas­cu­lar­iza­tion of the ­tumor and the fre­quent hemo­coag­u­la­tive alter­a­tions ­caused by the cir­rho­sis. The impor­tance of diag­nos­tic neu­ro­ra­diol­o­gy is brief­ly ­addressed, ­with ref­er­ence to the fun­da­men­tal ­role ­played by MRI. Surgery of ­these ­lesions ­does not ­present any par­tic­u­lar tech­ni­cal prob­lems as ­long as ­they are locat­ed in access­ible are­as and the ­patient’s gen­er­al and neu­ro­log­i­cal con­di­tions ­allow it. Posto-perative radio­ther­a­py ­seems to ­improve the qual­ity and quan­tity of resid­u­al ­life, ­although the num­ber of ­patients ­described in the lit­er­a­ture is too ­small to ­draw any def­i­nite con­clu­sions. Promising molec­u­lar biol­o­gy stud­ies are ­under way to eval­u­ate the ­role of onco­sup­pre­sor ­gene expres­sion in hepat­o­car­cin­o­gen­e­sis and in the way the dis­ease ­spreads.

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