A CASE OF HEPATOCELLULAR CARCINOMA COMPLICATED BY GASTRIC METASTASIS

Abstract

We reported a patient with hepatocellular carcinoma (HCC) complicated by gastric metastasis. The patient was 62-year-old male. He first admitted with epigastric fullness and was diagnosed to have HCC because of a high titer of AFP (6, 400 ng/ml) and by ultrasonographic and computed tomographic findings. Gastroscopic finding of an antral lesion was compatible with Borrmann III type gastric cancer. The biopsied specimens showed adenocarcinoma and this patient was assumed to have double cancers. The autopsy revealed the gastric tumor to be metastasis of HCC. Intraarterial injection of adriamycin-lipiodol emulsion and transcatheter arterial embolization to the primary lesion in the liver also made regression of the gastric tumor. Malignant cells had disappeared in biopsied tissues of the lesion. The gastric tumor decreased in size and turned to appear an ulcer scar. We could follow these changes endoscopically. The cause of death was hepatic failure due to advanced HCC. Metastasis was extended from the gastric antrum to the papilla of Vater and involved the head of the pancreas and around the choledocus, so the liver was obstructively jaundiced. The metastasis of HCC to the gastric mucosa rarely occurs and such case as observed endoscopically the improvement of the metastasis of HCC to the gastric mucosa seemed very rare.