Summary

Hepatocellular carcinoma is a common and aggressive malignancy the world over. Metastasis commonly occurs in lungs, bone, lymph node and adrenals. Skeletal muscle metastases from any primary is a rare occurrence, those occurring from hepatocellular carcinoma even more so. We present a case of a 61-year-old man presenting with hepatocellular carcinoma with synchronous symptomatic metastasis to the skeletal muscle. This article discusses approach to hepatocellular carcinoma with skeletal muscle metastases aetiopathogenesis, differential diagnosis and approach to treatment.