AFP and bone metastasis: The most common metastatic sites of HCO are peritoneum, intraperitoneal lymph node intraabdominal visceras such as liver, spleen, and distant hematogenous metastasis is less common.[19] Only one patient showed bone metastasis in the lumbar spine (L2) as in our case and was reported as alive after complete remission through radiation therapy without surgery.[14] Of the two patients who received radiation therapy for bone metastasis, our case showed a decrease in AFP after radiation treatment, which could help predict the effectiveness of the treatment.