Isolated Abdominal Wall Metastasis of Hepatocellular Carcinoma: A Case Report.

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and typically develops in the setting of chronic liver disease. Extrahepatic metastases usually occur in advanced disease stages and most frequently involve the lungs, bones, and lymph nodes, while metastasis to the abdominal wall is exceedingly rare. We report the case of a 74-year-old woman with chronic hepatitis B-related liver disease who was previously treated with curative-intent hepatectomy and later underwent percutaneous ablation for intrahepatic tumor recurrence. During routine surveillance, a solitary lesion of the right anterolateral abdominal wall was detected and histologically confirmed as metastatic HCC. Importantly, the lesion was anatomically distant from all prior surgical and percutaneous access sites, effectively excluding procedure-related tumor seeding as a mechanism of spread. Comprehensive staging revealed no additional metastatic disease, and the lesion was surgically excised. This case highlights an unusual pattern of extrahepatic dissemination of HCC and emphasizes the importance of careful anatomical assessment and long-term surveillance for the early detection of atypical metastatic disease.