A Case of Peritoneal Seeding from a Ruptured Hepatocellular Carcinoma with Direct Invasion into the Stomach Causing Gastrointestinal Hemorrhage.
- Author:
Dong Hee KIM
1
;
Jong Ryul EUN
;
Hee Jung MOON
;
Hee Ju OH
;
Yong Kil KIM
;
Byung Ik JANG
;
Tae Nyeun KIM
;
Heun Ju LEE
Author Information
1. Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. dreun@ynu.ac.kr
- Publication Type:Case Report ; English Abstract
- Keywords:
Hepatocellular carcinoma;
Gastric invasion;
Hemorrhage;
Peritoneal seeding
- MeSH:
Aged;
Carcinoma, Hepatocellular/*diagnosis/radiography/secondary;
Female;
Gastrointestinal Hemorrhage/*diagnosis/etiology/radiography;
Gastroscopy;
Humans;
Liver Neoplasms/*diagnosis/pathology/radiography;
*Neoplasm Seeding;
Peritoneal Neoplasms/*diagnosis/radiography/secondary;
Stomach Neoplasms/*diagnosis/radiography/secondary;
Tomography, X-Ray Computed
- From:The Korean Journal of Gastroenterology
2009;53(3):194-197
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Hepatocellular carcinoma (HCC) rarely invades the gastrointestinal (GI) tract. It occurs in 0.7% to 2% of clinical HCC cases. Moreover, gastric invasion with GI hemorrhage via peritoneal seeding is very rare. We report the case of 67-year-old woman who had a history of HCC rupture and was admitted due to left upper quadrant abdominal pain. The patient was diagnosed with three omental metastatic masses and underwent hepatic segmentectomy and omental tumorectomy. Two months later, the patient had massive melena, and an esophagogastroduodenoscopy showed very large ulcerated friable mass on the gastric body. The histology was consistent with the diagnosis of metastatic HCC. The patient died from persistent GI hemorrhage 93 days after the admission. This case illustrates the very rare event of peritoneal seeding of a ruptured HCC causing direct invasion of the stomach, followed by GI hemorrhage.
