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Herein, we write a case of a patient with no known liver disease, presenting with a pathological fracture of the proximal humerus bone secondary to a massive solitary metastasis from HCC. This case represents an unusual appendicular skeletal metastasis in a patient with unknown primary HCC, successfully treated with sorafenib. The prognosis of HCC patients with extrahepatic metastasis is poor, and in the presence of bone metastases, the mean survival rate is severely reduced. However, the multikinase inhibitor sorafenib has been the standard of treatment. Recently, there has been developments of other therapeutic class of drugs (i.e., immune check inhibitors), which have shown promising benefits and better side effect profiles. Still, there is a need for further studies, owing to challenges in recognizing cellular and molecular markers.<\/jats:p>","DOI":"10.1155\/2020\/8254236","type":"journal-article","created":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T01:59:39Z","timestamp":1606960779000},"page":"1-6","source":"Crossref","is-referenced-by-count":5,"title":["Hepatocellular Carcinoma: First Manifestation as Solitary Humeral Bone Metastasis"],"prefix":"10.1155","volume":"2020","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6680-4779","authenticated-orcid":true,"given":"Sumera","family":"Bukhari","sequence":"first","affiliation":[{"name":"Cambridge Health Alliance-Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Ward","sequence":"additional","affiliation":[{"name":"Pennsylvania Hospital-Penn Medicine, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Styler","sequence":"additional","affiliation":[{"name":"Fox Chase-Temple University Hospital, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.3055"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2015.0735"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.04.061"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19960601)77:11<2223::AID-CNCR7>3.0.CO;2-Q"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-199310000-00005"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2010.06341.x"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25960"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200109000-00015"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1007\/s00063-002-1166-4"},{"key":"10","first-page":"165","article-title":"Humerus metastasis revealing hepato-cellular carcinoma\u2014a rare case report : MR findings","volume":"13","author":"A. 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