When a road traffic accident leads to a skull metastasis from hepatocellular carcinoma: A unique case presentation

Background: Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver, responsible for significant morbidity and mortality worldwide. In the Western world, it primarily affects patients with cirrhosis, secondary to hepatitis C virus and alcoholism. In the rest of the world, HCC is closely associated with hepatitis B and C viruses infections. Skull metastasis from HCC is a rare presentation. Case description: We report a 53-year-old male who presented with a painless scalp lesion that was revealed to be due to a distant metastasis from an unnoticed HCC in a background of chronic hepatitis C virus. Conclusion: Isolated skull mass can be a rare and first presentation of extra-cranial malignancies including HCC. It is important to approach skulls mass with appropriate clinical, imaging and laboratory levels, since different lesions have different appropriate managements. The most effective method of management of scalp metastasis from HCC is the prevention of hepatitis infections, which could be achieved by effective screening programs in blood banks especially in the developing countries.