Long-term Survival after Surgery in a Patient with Small Bowel Metastasis of Hepatocellular Carcinoma:A Case Report and Literature Review
10.52927/jdcr.2026.14.1.115
- Author:
Je Seong KIM
1
;
Won Jae LEE
;
Chae June LIM
;
Young Eun SEO
;
Chan Muk IM
;
Hyung Hoon OH
;
Ki-Hyun KIM
;
Young Eun JOO
Author Information
1. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
- Publication Type:CASE REPORT
- From:
Journal of Digestive Cancer Research
2026;14(1):115-119
- CountryRepublic of Korea
- Language:English
-
Abstract:
Hepatocellular carcinoma (HCC) is a highly invasive tumor with a strong tendency for metastasis. The most common sites of metastasis are the lungs, followed by lymph nodes, adrenal glands, and bones. However, metastasis of HCC to the small bowel is extremely rare. A 42-yearold female with HCC secondary to chronic hepatitis B and lung metastasis underwent a right hepatic lobectomy, followed by two wedge resections performed via video-assisted thoracic surgery, four sessions of transcatheter arterial chemoembolization, and stereotactic body radiation therapy. She was under regular follow-up for HCC, during which her alpha-fetoprotein level increased to 722.2 IU/ml. Abdominal computed tomography (CT) revealed segmental wall thickening and aneurysmal dilatation of the small bowel loops. An 18 F-fluorodeoxyglucose positron emission tomography/CT scan demonstrated a 3.3-cm hypermetabolic mass-like lesion (standardized uptake value: 11.3) in the small bowel. Surgical resection of the affected small bowel segment was performed. Histopathological examination of the specimen confirmed metastatic HCC, with immunohistochemical positivity for hepatocyte-specific antigen. The patient has remained cancer-free for 60 months post-operatively. Surgical intervention may offer favorable long-term outcomes in patients with small bowel metastasis from HCC.
