Surgical salvage for sudden quadriplegia due to recurrent hepatocellular carcinoma with spinal metastasis

Ying-Chin Yang^a, Sheng-Tzung Tsai^b

^a Department of General Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
^b Department of Neurosurgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

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Abstract
The occurrence of spinal cord compression together with quadriplegia due to metastasis from hepatocellular carcinoma (HCC) is rare. There is a dilemma over whether to use aggressive treatment when metastases occur in multiple organs but death is not imminent. Herein, we report the case of a 45-year-old man who had sudden quadriplegia 22 months after undergoing a right hemihepatectomy for HCC. Both intrahepatic recurrence and extrahepatic spinal metastasis were found at that time. After an aggressive surgery for cervical spinal metastasis, he resumed walking and daily activities quickly. His postoperative ambulation time was at least 4.4 months. The patient could feed himself until the last 2 weeks of life. His survival was 6.8 months, even though he did not receive sorafenib.

Keywords
Extrahepatic metastasis; Hepatocellular carcinoma; Spinal metastasis