Small bowel metastasis of hepatocellular carcinoma detected by capsule endoscopy.
We report a rare case of metastasis of hepatocellular carcinoma (HCC) to the small bowel that presented as a pedunculated epithelial polyp. A 60-year-old man with liver cirrhosis type B was treated for HCC (stage IVb) at our hospital. He had been admitted for melena and anemia. Capsule endoscopy was performed in this patient with obscure gastrointestinal bleeding. It showed a polypoid lesion with bleeding in the ileum. Double-balloon endoscopy was performed. The lesion was determined to be a pedunculated polyp in the ileum. Histological examination of biopsy specimens showed tumor cells resembling HCC. We performed endoscopic mucosal resection for the lesion by double-balloon endoscopy to prevent bleeding from the tumor. The patient had no melena or anemia and his condition improved after endoscopic mucosal resection. However, he died of liver failure 2 months later.
Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
A
A
Igawa
Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
S
S
Oka
Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
S
S
Tanaka
Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
M
M
Nakano
Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
T
T
Aoyama
Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
I
I
Watari
Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
H
H
Aikata
Department of Pathology, Hiroshima University Hospital, Hiroshima, Japan.
K
K
Arihiro
Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
K
K
Chayama
Capsule endoscopy; Double-balloon endoscopy; Hepatocellular carcinoma; Small bowel metastasis