title: Unusual cause of gastrointestinal bleeding in a cirrhotic patient: hepatocellular carcinoma with gastric invasion.
abstract: BACKGROUND
  Upper gastrointestinal (GI) bleeding is a common complication of portal hypertension in cirrhotic patients, and hepatocellular carcinoma (HCC) is the most common tumor in cirrhotic livers. Bleeding from tumor erosion into the GI tract is very rare. A patient with HCC and gastric tumor invasion was described and the previously reported cases were reviewed.
  
  
  METHODS
  A patient with upper GI bleeding was treated in a tertiary hospital.
  
  
  RESULTS
  A cirrhotic patient with a HCC invading the stomach leading to upper GI bleeding was treated by left lateral segmentectomy and sub-total gastrectomy. The bleeding was controlled and a good surgical outcome was achieved.
  
  
  CONCLUSIONS
  HCC with gastric invasion should be differentially diagnosed from upper GI bleeding in cirrhotic patients. Bleeding can be controlled and symptomatic relief marked in selected cases.
authors: University of Sao Paulo School of Medicine, Department of Gastroenterology, Digestive Surgery Division, Sao Paulo, SP, Brazil. marcos.perini@usp.br
authors: Marcos Vinicius
authors: MV
authors: Perini
authors: Paulo
authors: P
authors: Herman
authors: Rodrigo
authors: R
authors: Pessoa
authors: Willian Abraao
authors: WA
authors: Saad
authors: Luiz Augusto Carneiro
authors: LA
authors: D'Albuquerque
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D017809:Fatal Outcome; D005743:Gastrectomy; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006489:Hemostatic Techniques; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications* / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D008297:Male; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D013270:Stomach / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome