case_images: PMC3891166_01
case_images: Computed tomography showing a huge hepatic mass on arterial phase.
case_images: kjim-20-268-g001.jpg
case_images: PMC3891166_01_kjim-20-268-g001.jpg
case_images: F1
case_images: Abdominal enhanced computerized tomography (CT) scanning also revealed the same findings with right portal vein invasion (Figure 1).
case_images: (A) Initial chest X-ray showing no abnormalities. (B) Chest X-ray showing chest wall metastasis with invading adjacent ribs after 3 months. (C) Chest X-ray showing growing chest wall mass compared to previous images.
case_images: kjim-20-268-g002.jpg
case_images: PMC3891166_01_kjim-20-268-g002.jpg
case_images: F2
case_images: A chest X-ray showed a lesion which was invading the rib on the left upper lung (Figure 2). The mass size slowly increased up to 10x10 cm in diameter during the follow-up period (Figure 2).
case_images: (A) Computed tomography showing a metastatic mass invading the left sacrum. (B) Computed tomography showing decreased hepatic mass compared to initial scan.
case_images: kjim-20-268-g003.jpg
case_images: PMC3891166_01_kjim-20-268-g003.jpg
case_images: F3
case_images: HCC had decreased in size (about 4x3 cm) (Figure 3). His serum AFP was above 500 ng/mL.
case_images: Microscopic findings of clear cell hepatocellular carcinoma. Biopsy specimen from left anterior chest wall revealed eccentric nucleoli with vacuolated foamy-to-clear cytoplasm that did not stain with hematoxylin and eosin (x100)
case_images: kjim-20-268-g004.jpg
case_images: PMC3891166_01_kjim-20-268-g004.jpg
case_images: F4
case_images: Microscopic examination showed necrosis and eccentric nucleoli with vacuolated foamy-to-clear cytoplasm that did not stain with hematoxylin and eosin (Figure 4).
case_images: (A) Computed tomography showing a thickened left anterior chest wall but no mass lesion. (B) Computed tomography showing a further decreased hepatic mass lesion compared to previous images.
case_images: kjim-20-268-g005.jpg
case_images: PMC3891166_01_kjim-20-268-g005.jpg
case_images: F5
case_images: A CT scan revealed the same findings, and on the scanned upper-abdominal imaging, a further decrease in the primary lesion (about 3x2 cm) was noted (Figure 5).
case_images: Schematic presentation on the course of serum AFP level, liver mass size, chest wall lesion, and sacral lesion during follow-up.
case_images: kjim-20-268-g006.jpg
case_images: PMC3891166_01_kjim-20-268-g006.jpg
case_images: F6
case_images: Additionally, his serum AFP has decreased to 8.0 ng/mL (Figure 6).