Cutaneous Seeding of Hepatocellular Carcinoma Due to Percutaneous Ethanol Injection and Masquerading as a Pyogenic Granuloma

Background. This investigation reports a 68-year-old man with a history of hepatocellular carcinoma (HCC) diagnosed 2 years previously who developed a single, easy-bleeding, pyogenic granuloma (PG)-like lesion on his right upper abdomen, located in the area of previous therapeutic percutaneous ethanol injection (PEI) for HCC treatment. The lesion developed 3 months after the injection. The tumor was found to be identical to his previous HCC. Objective. To describe a case of cutaneous seeding of HCC during PEI presented as a PG-like lesion. To our knowledge, this is the first such case reported in the literature. Methods. This is a case report and review the literature. Results. Immunostainings for α-fetoprotein and hepatocyte monoclonal antibody confirmed the diagnosis. Besides, the patient had no other metastatic lesion. Conclusion. This tumor is believed to be caused by cutaneous seeding of HCC during PEI and is simulated clinically as a PG.