20.500.12556/DiRROS-26999 Clival metastasis of hepatocellular carcinoma a case report of a rare skull-base malignancy Introduction: Hepatocellular carcinoma is the most common neoplasm of the liver. It metastasizes mainly to local lymph nodes, lungs, adrenal glands, vertebrae, pelvis, ribs and long bones. Metastasis to the clivus is extremely rare. Only a few cases have been described in the literature. Therefore, there is currently no clear consensus on the optimal treatment: biopsy only or maximum safe removal.Case report: We present a 68-year-old lady who presented with dysfunction of the 6th and 12th cranial nerves. Imaging showed tumor formation in the clivus, most likely a metastasis. Further diagnostics revealed no clear primary tumor. The patient therefore underwent surgery for local decompression and simultaneous biopsy for pathohistologic examinations. These showed that the most likely metastasis was a hepatocellular carcinoma. Subsequent diagnostics revealed highly elevated alpha-feto protein levels and liver MR revealed a suspected multifocal hepatocellular carcinoma only after correlation with the pathohistologic findings. One month after surgery, the condition suddenly worsened due to severe local recurrence and hemorrhage. This was followed by palliative oncological treatment with whole head irradiation.Conclusion: In the case of a suspected clivus metastasis of unknown origin, it is reasonable to take tumor markers. This increases the likelihood of an appropriate diagnosis and avoids unnecessary and risky surgery. If all tests are inconclusive, a biopsy of the lesion is the diagnostic gold standard. The treatment of metastatic disease in the clivus (in our case a hepatocellular carcinoma) remains palliative. hepatocellular carcinoma clivus metastasis endoscopic endonasal surgery case report true false true Angleški jezik Ni določen Neznano 2026-01-28 12:39:53 2026-01-28 12:39:54 2026-01-31 04:14:12 0000-00-00 00:00:00 2026 0 0 Nasl. z nasl. zaslona; Opis vira z dne 28. 1. 2026; str. 1-8 [article no.] 1567187 Vol. 15 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616-006 2234-943X 10.3389/fonc.2025.1567187 266458627 RAZ_Felbabic_Tomislav_2026.pdf RAZ_Felbabic_Tomislav_2026.pdf 1 417D892E3A489F9B8D50657E5842346B 62afaba8f7868afc329192abe8066c029f4d767f4137ddc922d1708990143b2f 28e52f8f-fc3e-11f0-a15d-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=39621 https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1567187 0 3684cf19-fc3e-11f0-a15d-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=39622 Univerzitetni klinični center Ljubljana 0 0 0