Open AccessHepatocellular carcinoma masquerading as a bleeding gastric ulcer: A case report and a review of the surgical management
Author(s) -
Chin-Ann Johnny Ong,
Pierce K.H. Chow,
WengHoong Chan,
Alex Chung,
Choon Hua Thng,
WaiKeong Wong
Publication year - 2007
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v13.i33.4523
Subject(s) - medicine , hepatocellular carcinoma , malignancy , gastrointestinal tract , surgery , gastrointestinal bleeding , gastroenterology , hepatectomy , endoscopy , stomach , endoscopic mucosal resection , general surgery , resection
Hepatocellular Carcinoma (HCC) is a common malignancy worldwide. While bleeding from the gastrointestinal tract (BGIT) has a well known association with HCC, such cases are mainly due to gastric and esophageal varices. BGIT as a result of invasion of the gastrointestinal tract by HCC is extremely rare and is reportedly associated with very poor prognosis. We describe a 67-year-old male who presented with BGIT. Endoscopy showed the site of bleeding to be from a gastric ulcer, but endoscopic therapy failed to control the bleeding and emergency surgery was required. At surgery, the ulcer was found to have arisen from direct invasion of the gastrointestinal tract by HCC of the left lobe. Control of the bleeding was achieved by surgical resection of the HCC en-bloc with the lesser curve of the stomach. The patient remains alive 33 mo after surgery. Direct invasion of the gastrointestinal tract by HCC giving rise to BGIT is very uncommon. Surgical resection may offer significantly better survival over non-surgical therapy, especially if the patient is a good surgical candidate and has adequate functional liver reserves. Prognosis is not uniformly grave.