title: Rare cause of upper gastrointestinal bleeding owing to hepatic cancer invasion: a case report.
abstract: Upper gastrointestinal bleeding refers to bleeding that arises from the gastrointestinal tract proximal to the ligament of Treitz. The primary reason for gastrointestinal bleeding associated with hepatocellular carcinoma is rupture of a varicose vein owing to pericardial hypotension. We report a rare case of gastrointestinal bleeding with hepatocellular carcinoma in a patient who presented with recurrent gastrointestinal bleeding. The initial diagnosis was gastric cancer with metastasis to the multiple lymph nodes of the lesser curvature. The patient underwent exploratory laparotomy, which identified two lesions in the gastric wall. Total gastrectomy and hepatic local excision was then performed. Pathological results indicated that the hepatocellular carcinoma had invaded the stomach directly, which was confirmed immunohistochemically. The patient is alive with a disease-free survival of 1 year since the surgery. Hepatocellular carcinoma with gastric invasion should be considered as a rare cause of upper gastrointestinal bleeding in hepatocellular carcinoma patients, especially with lesions located in the left lateral hepatic lobe. Surgery is the best solution.
authors.affiliation: Wei-Ding Wu, Jia Wu, Cheng-Wu Zhang, Da-Jian Zhao, Zhi-Ming Hu, Department of Hepatopancreatobiliary surgery and Minimally invasive surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang Province, China.
authors.forename: Wei-Ding
authors.initials: WD
authors.lastname: Wu
authors.affiliation: Wei-Ding Wu, Jia Wu, Cheng-Wu Zhang, Da-Jian Zhao, Zhi-Ming Hu, Department of Hepatopancreatobiliary surgery and Minimally invasive surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang Province, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Wu
authors.affiliation: Wei-Ding Wu, Jia Wu, Cheng-Wu Zhang, Da-Jian Zhao, Zhi-Ming Hu, Department of Hepatopancreatobiliary surgery and Minimally invasive surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang Province, China.
authors.forename: Hong-Guo
authors.initials: HG
authors.lastname: Yang
authors.affiliation: Wei-Ding Wu, Jia Wu, Cheng-Wu Zhang, Da-Jian Zhao, Zhi-Ming Hu, Department of Hepatopancreatobiliary surgery and Minimally invasive surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang Province, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Wei-Ding Wu, Jia Wu, Cheng-Wu Zhang, Da-Jian Zhao, Zhi-Ming Hu, Department of Hepatopancreatobiliary surgery and Minimally invasive surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang Province, China.
authors.forename: Cheng-Wu
authors.initials: CW
authors.lastname: Zhang
authors.affiliation: Wei-Ding Wu, Jia Wu, Cheng-Wu Zhang, Da-Jian Zhao, Zhi-Ming Hu, Department of Hepatopancreatobiliary surgery and Minimally invasive surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang Province, China.
authors.forename: Da-Jian
authors.initials: DJ
authors.lastname: Zhao
authors.affiliation: Wei-Ding Wu, Jia Wu, Cheng-Wu Zhang, Da-Jian Zhao, Zhi-Ming Hu, Department of Hepatopancreatobiliary surgery and Minimally invasive surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang Province, China.
authors.forename: Zhi-Ming
authors.initials: ZM
authors.lastname: Hu
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000737:chemistry / Q000150:complications* / Q000473:pathology / Q000601:surgery; D005743:Gastrectomy; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D006498:Hepatectomy; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000737:chemistry / Q000150:complications* / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness; D012008:Recurrence; D013274:Stomach Neoplasms / Q000737:chemistry / Q000150:complications* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor
keywords: Bleeding; Cancer; Gastrointestinal tract; Liver; Neoplasm invasion