Bone metastases as initial presentation of hepatocellular carcinoma

Figure 1 Clinical case 1. A: Axial pelvic MRI T1-weighted imaging showing a large mass in the soft planes with lytic lesion on right iliac blade, markedly hypointense (asterisk); B: Coronal pelvic MRI T1-weighted imaging after administration of intravenous GD-DTPA contrast showing the mass with intense enhancement after administration of contrast (asterisk); C: Biopsy of pelvic mass (hematoxylin-eosin staining, 20 × magnification) showing broad metastatic presentation by well-differentiated HCC; D: Multiphasic liver MDCT showing hepatic focal lesion in segment IV (white arrow) with arterial phase enhancement; E: Multiphasic liver MDCT showing the lesion with slight washout in the portal phase (white arrow); F: Multiphasic liver MDCT showing the lesion as isodense with respect to the parenchyma in the equilibrium phase. HCC: Hepatocellular carcinoma; MDCT: Multidetector computed tomography; MRI: Magnetic resonance imaging.