A case of iliac bone metastasis in a hepatocellular carcinoma patient who survived for more than five years after radiotherapy

A 50-year-old man attended our hospital after being diagnosed to have solitary iliac bone metastasis from hepatocellular carcinoma. He underwent hepatic anterior-segmentectomy 10 months prior to this presentation for a hepatocellular carcinoma tumor measuring 70 mm in diameter and comprising 5_8 segment of the liver. No evidence of recurrence was visible in the liver. After he received 51 Gy of radiotherapy and 4 mg of Zoledronic acid were administered five times, his pain improved and the tumor markers all normalized thereafter. The bone metastasis also stabilized and transformed into ossification. The patient has since survived without recurrence for six years after the diagnosis of bone metastasis. Most patients presenting with bone metastases of hepatocellular carcinoma have a poor prognosis. However, patients demonstrating solitary bone metastasis may achieve a long-term survival, namely more than five years, when such cases have a good liver function and has no lesions in the postsurgical liver. It is therefore necessary to select the optimal combined modality therapy for such patients while assuming a potential long-term survival.