Vertebral metastasis with spinal cord compression as the first manifestation of hepatocellular carcinoma: a case report

This case highlights the variability in hepatocellular carcinoma presentations and underscores the need for heightened clinical vigilance in patients presenting with unexplained bone or neurological symptoms, even in the absence of overt hepatic signs. Skeletal metastases are rare in this tumor compared with other cancers. The diagnosis can be even more challenging when bone metastases are the predominant initial manifestation, particularly when neurological complications emerge early in the course of disease.