Metastatic hepatocellular carcinoma to bone in a liver transplant patient: A case report

Although previously unreported in the orthopaedic literature, hepatocellular carcinoma metastasizes to bone in 2 to 20% of cases. The poor prognosis associated with this tumor often results in patient demise before the need for orthopaedic intervention. A liver transplant recipient with no known history of hepatocellular carcinoma was diagnosed with this tumor when open reduction and internal fixation of an impending pathologic femoral fracture were performed. Metastatic hepatocellular carcinoma should be considered in the differential diagnosis of a lytic osseous metastasis in appropriate patient populations.