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Cryosurgical cranioplasty using autologous bone for metastatic skull lesion from hepatocellular carcinoma: illustrative case.

Year: 2026

Type: article

Abstract: BACKGROUND: Skull metastases from hepatocellular carcinoma (HCC) are rare and may cause significant neurological deficits. Conventional cranioplasty using titanium mesh or polyetheretherketone can result in imaging artifacts and implant-related complications. Cryotherapy provides a potential means to sterilize tumor-infiltrated autologous bone for reuse in reconstruction. OBSERVATIONS: A man in his 50s with hepatitis B virus-associated HCC presented with cognitive and speech disturbances. Imaging revealed a 5-cm left temporo-parieto-occipital skull lesion with intracranial extension. The tumor-infiltrated bone flap was excised, treated with liquid nitrogen at -60°C to -80°C for 20 minutes, and reimplanted after tumor resection. Histopathology confirmed metastatic HCC involving the skull and brain. Three-month follow-up MRI and CT demonstrated no recurrence, excellent bone flap integration, and no imaging artifacts. The patient's neurological symptoms were resolved postoperatively. LESSONS: Cryosurgical cranioplasty using autologous bone offers a biologically compatible, imaging-friendly, and oncologically safe alternative to synthetic implants for metastatic skull lesions, enabling effective reconstruction and reliable postoperative surveillance. https://thejns.org/doi/10.3171/CASE25852.

Source: PubMed

DOI: 10.3171/case25852

Authors: Chan-Wei Liu, Tsung-Hsi Tu, Jau-Ching Wu, Wen-Cheng Huang, Chao-Hung Kuo

Institutions: National Yang Ming Chiao Tung University, Taipei Veterans General Hospital, Taipei Medical University

Language: English

Topic: Management of metastatic bone disease

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

OpenAlex ID: W7119496985

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