title: Hepatocellular carcinoma with gastric metastasis treated by simultaneous hepatic and gastric resection: report of a case.
abstract: Hepatocellular carcinoma (HCC) with gastric metastasis is extremely rare. There have been few reports on curative surgical resection for gastric metastasis of HCC. We herein report such a case successfully treated by simultaneous surgical resection. A 73-year-old male was admitted for evaluation and treatment of a liver tumor. Computed tomography showed an exophytic tumor of 170 mm in diameter located in the left lobe of the liver with poor delineation to the gastric wall. Upper gastrointestinal endoscopy revealed a submucosal tumor with ulceration in the antrum of the stomach. With a diagnosis of HCC with invasion to the gastric wall, an en bloc resection was planned, and the patient underwent laparotomy. The patients underwent left hemihepatectomy with partial resection of the stomach for adhesion and distal gastrectomy for the tumor. Pathological examination of the liver tumor revealed poorly differentiated HCC, and pathological diagnosis of the tumor in the submucosal and muscular layer of the stomach was compatible with metastasis from HCC, which was separate from the liver tumor. Therefore, we diagnosed the tumor as HCC with hematogenous gastric metastasis. The patient remains well with no evidence of tumor recurrence as of 13 months after resection.
authors.affiliation: Department of Surgery, Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan. haruki@jikei.ac.jp.|Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan. haruki@jikei.ac.jp.
authors.forename: Koichiro
authors.identifier: http://orcid.org/0000-0002-1686-3228
authors.initials: K
authors.lastname: Haruki
authors.affiliation: Department of Surgery, Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan.|Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Misawa
authors.affiliation: Department of Surgery, Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan.|Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Gocho
authors.affiliation: Department of Surgery, Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan.|Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Saito
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiba
authors.affiliation: Department of Surgery, Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan.|Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Akiba
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D005743:Gastrectomy / Q000379:methods; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Gastric metastasis; Hepatocellular carcinoma; Surgical resection