Radiologic findings of gastrointestinal tract involvement in hepatocellular carcinoma.
OBJECTIVE
The purpose of this work was to evaluate the radiologic findings of gastrointestinal (GI) tract involvement in hepatocellular carcinoma (HCC) and to discuss mechanisms of spread.


METHODS
Eighteen patients with histologically proven GI tract metastasis in HCC for 4.5 years underwent CT and five also underwent upper GI (UGI) series. The cases were classified according to the mode of spread, based on the radiologic findings.


RESULTS
The involved portion of the GI tract was the stomach (n = 11), duodenum (n = 4), and colon (n = 4). The mode of spread was direct invasion from a contiguous primary tumor (n = 12), hematogenous metastasis (n = 3), peritoneal seeding (n = 1), and undetermined (n = 2). In cases of direct invasion from contiguous primary tumors, CT revealed GI tract invasion directly from bulky hepatic masses (n = 9) or daughter masses at the portion of the bowel wall contiguous to the hepatic masses (n = 3). In cases of hematogenous spread, CT revealed an intramural mass in the stomach and duodenum (n = 2) or a diffuse thickening of the wall of the stomach (n = 1). In the case of peritoneal seeding, CT revealed multiple small nodules in the right paracolic gutter, omentum, and mesentery with invasion to the colon.


CONCLUSIONS
GI tract involvement in HCC shows various radiologic findings according to the mode of spread, but the most common finding is direct invasion of the stomach, duodenum, or colon from contiguous primary tumor.
Park
Mi-Suk
MS
Department of Diagnostic Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea.
Kim
Ki Whang
KW
Yu
Jeong-Sik
JS
Kim
Myeong-Jin
MJ
Yoon
Sang-Wook
SW
Chung
Ki-Woong
KW
Lee
Jong Tae
JT
Yoo
Hyung Sik
HS
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000556:secondary*; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D004379:Duodenal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D014057:Tomography, X-Ray Computed