Gastrointestinal bleeding and esophageal varices are adverse events that can occur following the introduction of molecular-targeted drugs for hepatocellular carcinoma. We report a case of ruptured gastric varices after the introduction of a molecular-targeted drug. The patient underwent repeated hepatic artery chemoembolization for hepatocellular carcinoma. Sorafenib was introduced for lung metastasis, followed by the progression of anemia. An upper gastrointestinal endoscopy confirmed the diagnosis of ruptured gastric varices, and endoscopic variceal sclerotherapy was performed. In this case, stable gastric varices ruptured after the introduction of sorafenib, suggesting that sorafenib was likely involved in the variceal rupture. Careful follow-up or pre-introduction sclerotherapy and IVR may be necessary when administering molecular-targeted drugs to patients with gastric varices.
