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.
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References
Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–917.
Natsuizaka M, Omura T, Akaike T, et al. Clinical features of hepatocellular carcinoma with extrahepatic metastases. J Gastroenterol Hepatol. 2005;20:1781–7.
Uchino K, Tateishi R, Shiina S, et al. Hepatocellular carcinoma with extrahepatic metastasis: clinical features and prognostic factors. Cancer. 2011;117:4475–83.
Bruix J, Sherman M. Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology. 2005;42:1208–36.
Li L, Zhang WH, Meng FP, et al. Gastric metastasis of hepatocellular carcinoma with gastrointestinal bleeding after liver transplant: a case report. Transplant Proc. 2015;47:2544–7.
Chen LT, Chen CY, Jan CM, et al. Gastrointestinal tract involvement in hepatocellular carcinoma: clinical, radiological and endoscopic studies. Endoscopy. 1990;22:118–23.
Lin CP, Cheng JS, Lai KH, et al. Gastrointestinal metastasis in hepatocellular carcinoma: radiological and endoscopic studies of 11 cases. J Gastroenterol Hepatol. 2000;15:536–41.
Hu ML, Tai WC, Chuah SK, et al. Gastric metastasis of hepatocellular carcinoma via a possible existing retrograde hematogenous pathway. J Gastroenterol Hepatol. 2010;25:408–12.
Sano T, Izuishi K, Takebayashi R, et al. Surgical approach for extrahepatic metastasis of HCC in the abdominal cavity. Hepatogastroenterology. 2011;58:2067–70.
Qian L, Huang J, Qin H. Glypican-3-expressing gastric metastasis of hepatocellular carcinoma via curative subtotal gastrectomy: a case report. J Gastrointest Cancer. 2014;45:166–9.
Katyal S, Oliver JH 3rd, Peterson MS, et al. Extrahepatic metastases of hepatocellular carcinoma. Radiology. 2000;216:698–703.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).
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Haruki, K., Misawa, T., Gocho, T. et al. Hepatocellular carcinoma with gastric metastasis treated by simultaneous hepatic and gastric resection: report of a case. Clin J Gastroenterol 9, 319–323 (2016). https://doi.org/10.1007/s12328-016-0677-0
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DOI: https://doi.org/10.1007/s12328-016-0677-0