title: Hepatocellular carcinoma with gastrointestinal hemorrhage caused by direct tumor invasion to the duodenum.
abstract: Gastrointestinal hemorrhage from hepatocellular carcinoma invading the duodenum is very rare. A 60-year-old man with multiple hepatocellular carcinoma was admitted to our hospital because of massive melena and hematemesis. We succeeded in hemostasis of an esophageal variceal rupture by endoscopic varicial ligation. The duodenum could not be observed endoscopically due to extramural compression to the stomach from the liver tumor. Massive gastrointestinal hemorrhage occurred again and the patient died of hepatic failure. The postmortem examination revealed that the liver tumor had invaded the second portion of the duodenum and perforated into the lumen.
authors.affiliation: Department of Internal Medicine, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Okusaka
authors.forename: S
authors.initials: S
authors.lastname: Okada
authors.forename: H
authors.initials: H
authors.lastname: Ishii
authors.forename: H
authors.initials: H
authors.lastname: Nagahama
authors.forename: M
authors.initials: M
authors.lastname: Yoshimori
authors.forename: S
authors.initials: S
authors.lastname: Yamasaki
authors.forename: K
authors.initials: K
authors.lastname: Takayasu
authors.forename: T
authors.initials: T
authors.lastname: Kakizoe
authors.forename: A
authors.initials: A
authors.lastname: Ochiai
authors.forename: T
authors.initials: T
authors.lastname: Shimoda
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000473:pathology*; D004379:Duodenal Neoplasms / Q000150:complications / Q000473:pathology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness