Cutaneous metastasis of hepatocellular carcinoma following liver transplantation

Cutaneous metastases from hepatocellular carcinoma (HCC) are extremely rare and can represent a sign of an underlying malignancy or relapse/progression from an existing tumor. We report a case of a cutaneous metastasis arising in a patient with metastatic HCC following orthotopic liver transplantation. Diagnosis is a multistep process as cutaneous HCC metastases must be differentiated from primary cutaneous malignancies as well as other cutaneous metastases. Making this even more challenging, HCC metastases have heterogeneous clinical and histologic appearances. Therefore, the use of immunohistochemical stains, including hepatocyte paraffin-1, arginase-1, and glypican-3, and correlation with the clinical context are essential for a correct diagnosis.