title: A case of extrahepatic growth-type hepatocellular carcinoma presenting with bleeding from colonic metastasis.
abstract: A 60-year-old woman visited our hospital due to hematochezia. Colonoscopy revealed a 50-mm-diameter submucosal tumor with ulceration of the left side of the transverse colon, and magnetic resonance imaging (MRI) demonstrated the presence of small hepatic nodules. Submucosal tumor of the colon with liver metastasis was therefore diagnosed. To prevent tumor bleeding, we performed partial transverse colectomy. The histopathological diagnosis was moderately differentiated hepatocellular carcinoma presenting as a submucosal tumor with a high frequency of vascular invasion. Computed tomography (CT) angiography revealed a 40-mm-diameter confluent multinodular-type hepatocellular carcinoma with outward spread from segment II and multiple intrahepatic metastases. Our final diagnosis was hepatocellular carcinoma with hematogenous colon metastasis.
authors.affiliation: Center for Gastroenterology, Teine-Keijinkai Hospital.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tanaka
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Tsuji
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsui
authors.forename: Jong-Hon
authors.initials: JH
authors.lastname: Kang
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sakurai
authors.forename: Akihiro
authors.initials: A
authors.lastname: Takiyama
authors.forename: Toshiya
authors.initials: T
authors.lastname: Shinohara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Maguchi
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000556:secondary; D003082:Colectomy; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D003113:Colonoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D064847:Multimodal Imaging; D014057:Tomography, X-Ray Computed