Hepatocellular carcinoma (HCC) is a common malignancy of the liver. It frequently arises in patients with chronic hepatitis infections, with extrahepatic metastases, particularly to bone, typically occurring several months after initial diagnosis. We present a rare case of a 71-year-old female with a 22-year history of hepatitis C infection, and a three-year history of liver cirrhosis. During routine evaluation, a liver ultrasound revealed ill-defined lesions in both liver lobes. Subsequent contrast-enhanced computed tomography (CT) of the liver confirmed the diagnosis of hepatocellular carcinoma.

The patient was referred to the oncology department for further management. Remarkably, within three weeks, the patient developed diffuse bone pain, prompting additional investigation. A bone scan revealed widespread skeletal metastases, indicating a rare, rapid progression of HCC. She was initiated on high-dose analgesics and received symptomatic care for other associated symptoms, which provided partial relief. This case highlights the potential for aggressive tumor behavior and the importance of early recognition of atypical metastatic presentations. This also underscores the need for more clinical awareness and prompt diagnostic imaging similar presentations. Clinicians should maintain a high index of suspicion for bone metastasis in newly diagnosed HCC patients presenting with new-onset bone pain, even in early stages of diagnosis. Early detection and timely palliative intervention are crucial for improving patient outcomes.

She graduated from quaid e azam medical college. She is deeply interested in medicine and driven by a strong desire to help others. His academic journey has been shaped by curiosity, dedication, and a commitment to continuous learning. She enjoy understanding disease processes and applying medical knowledge to improve patient care.

She have a keen interest in medical research and actively participate in research activities, including meta-analyses, case reports, and several observational studies. These experiences have strengthened my skills in literature review, data interpretation, and critical appraisal, while deepening my understanding of evidence-based medicine.