title: [A case of peritoneal seeding from a ruptured hepatocellular carcinoma with direct invasion into the stomach causing gastrointestinal hemorrhage].
abstract: 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.
authors.affiliation: Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Dong Hee
authors.initials: DH
authors.lastname: Kim
authors.forename: Jong Ryul
authors.initials: JR
authors.lastname: Eun
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Moon
authors.forename: Hee Ju
authors.initials: HJ
authors.lastname: Oh
authors.forename: Yong Kil
authors.initials: YK
authors.lastname: Kim
authors.forename: Byung Ik
authors.initials: BI
authors.lastname: Jang
authors.forename: Tae Nyeun
authors.initials: TN
authors.lastname: Kim
authors.forename: Heun Ju
authors.initials: HJ
authors.lastname: Lee
mesh_terms: 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