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Gastrointestinal metastasis in hepatocellular carcinoma: Radiological and endoscopic studies of 11 cases
Author(s) -
Lin ChiPin,
Cheng JinShiung,
Lai KwokHung,
Lo GinHo,
Hsu PinI,
Chan HoiHung,
Hsu JuiHung,
Wang YaYu,
Pan HuayBen,
Tseng HuiHwa
Publication year - 2000
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2000.02152.x
Subject(s) - medicine , hepatocellular carcinoma , radiological weapon , metastasis , radiology , carcinoma , general surgery , gastroenterology , oncology , cancer
Background: From October 1990 to January 1999, 11 of 2237 hepatoma patients at our hospital had gastrointestinal tract metastasis. We describe the radiological and endoscopic features, clinical course and prognoses of those patients.Methods: All patients were male. Six patients were hepatitis B carriers, and cirrhosis was noted in eight patients on admission. We reviewed all available radiological, endoscopic and pathological features.Results: The commonest clinical presentation was frank gastrointestinal bleeding. Histological proof of gastrointestinal involvement was seen in six patients. Endoscopic features included ulcerative tumours mimicking advanced gastric carcinoma (43%) and submucosal tumours (29%). The sites of organ involvement were stomach (five), duodenum (two), colon (three) and duodenum and colon (one). Direct invasion by a contiguous neoplasm was the major route of gastrointestinal tract metastasis. Portal vein thrombosis may be the key point of haematogenous spread to other sites.Conclusions: The prognosis in these patients was extremely poor. Almost all patients died within 5 months if no further aggressive management was performed. Surgical intervention may be the optimal choice for palliative treatment of HCC with gastrointestinal tract involvement.