ArticleJournal of neurosurgery. Case lessons2026
Cryosurgical cranioplasty using autologous bone for metastatic skull lesion from hepatocellular carcinoma: illustrative case.
Article in Journal of neurosurgery. Case lessons, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSkull 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.
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