Korean J Gastroenterol.  2009 Mar;53(3):194-197.

A Case of Peritoneal Seeding from a Ruptured Hepatocellular Carcinoma with Direct Invasion into the Stomach Causing Gastrointestinal Hemorrhage

• Kim DH
• Eun JR
• Moon HJ
• Oh HJ
• Kim YK
• Jang BI
• Kim TN
• Lee HJ

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.

Keyword

Hepatocellular carcinoma; Gastric invasion; Hemorrhage; Peritoneal seeding

MeSH Terms

Aged
Carcinoma, Hepatocellular/*diagnosis/radiography/secondary
Female
Gastrointestinal Hemorrhage/*diagnosis/etiology/radiography
Gastroscopy
Humans
Liver Neoplasms/*diagnosis/pathology/radiography
*Neoplasm Seeding
Peritoneal Neoplasms/*diagnosis/radiography/secondary
Stomach Neoplasms/*diagnosis/radiography/secondary
Tomography, X-Ray Computed