Abstract / Summary
Hepatocellular Carcinoma (HCC) is an aggressive malignancy with a strong propensity for vascular invasion and distant metastasis, although presentation with isolated bone lesions remains uncommon. The diagnosis of metastatic HCC can be challenging in patients lacking underlying liver-related symptoms or known chronic liver disease. In this report, authors present an exceptionally rare case of a 70-year-old male presenting with right scapular pain and swelling as the primary manifestation of HCC with bone metastasis. Because appendicular skeletal involvement is rare-with fewer than 10 cases of scapular metastasis documented-and patients frequently lack abdominal symptoms, initial misdiagnosis is common. Given the highly vascular nature of HCC metastases, these lesions carry a significant risk of acute vascular complications. This case emphasises the importance of including HCC in the differential diagnosis of atypical osteolytic lesions. A multidisciplinary approach integrating advanced imaging, histopathology, and immunohistochemistry is essential for timely diagnosis and appropriate management.