case_images: PMC11080690_01
case_images: Left parietal mass at the thoracic level, located in the center of the 3rd rib, and accompanied by a lytic bone lesion
case_images: GHFBB-17-93-g001.jpg
case_images: PMC11080690_01_GHFBB-17-93-g001.jpg
case_images: F1
case_images: However, a left parietal mass was identified at the thoracic level, located in the center of the 3rd rib, and accompanied by a lytic bone lesion, which could potentially indicate a primary sarcoma or a secondary lesion (Figure 1).
case_images: Multiphase MRI (left) and CT (right) scan showing signs of cirrhosis with moderate ascites and portal vein thrombosis, without focal liver lesion
case_images: GHFBB-17-93-g002.jpg
case_images: PMC11080690_01_GHFBB-17-93-g002.jpg
case_images: F2
case_images: To rule out an infiltrative pattern of HCC, an MRI was conducted, which did not reveal any hepatic lesion (Figure 2).
case_images: Histological examination of core needle biopsy showed a carcinoma with hepatoid features, including trabecular pattern and large cells with round nuclei and eosinophilic or clarified cytoplasm, expressing glypican 3 and HerPar1 at immunohistochemistry
case_images: GHFBB-17-93-g003.jpg
case_images: PMC11080690_01_GHFBB-17-93-g003.jpg
case_images: F3
case_images: The patient underwent an ultrasound-guided biopsy of the 3rd rib lesion, and the histological examination showed a carcinoma with hepatoid features, including trabecular pattern and large cells with round nuclei plus eosinophilic or clarified cytoplasm, expressing glypican 3 and HerPar1 at immunohistochemistry (Figure 3), all being consistent with histological and immunophenotypical characteristics of a moderately differentiated secondary lesion of HCC.