[A case of peritoneal seeding from a ruptured hepatocellular carcinoma with direct invasion into the stomach causing gastrointestinal hemorrhage].
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.
Kim
Dong Hee
DH
Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Eun
Jong Ryul
JR
Moon
Hee Jung
HJ
Oh
Hee Ju
HJ
Kim
Yong Kil
YK
Jang
Byung Ik
BI
Kim
Tae Nyeun
TN
Lee
Heun Ju
HJ
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D005773:Gastroscopy; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D009366:Neoplasm Seeding; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary; D014057:Tomography, X-Ray Computed