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Japanese Journal of Clinical Oncology, Vol 27, Issue 5 343-345, Copyright © 1997 by Foundation for Promotion of Cancer Research

ORIGINAL ARTICLE

Hepatocellular carcinoma with gastrointestinal hemorrhage caused by direct tumor invasion to the duodenum

T Okusaka, S Okada, H Ishii, H Nagahama, M Yoshimori, S Yamasaki, K Takayasu, T Kakizoe, A Ochiai and T Shimoda
Department of Internal Medicine, National Cancer Center Hospital, Tokyo, Japan.

Gastrointestinal hemorrhage from hepatocellular carcinoma invading the duodenum is very rare. A 60-year-old man with multiple hepatocellular carcinoma was admitted to our hospital because of massive melena and hematemesis. We succeeded in hemostasis of an esophageal variceal rupture by endoscopic varicial ligation. The duodenum could not be observed endoscopically due to extramural compression to the stomach from the liver tumor. Massive gastrointestinal hemorrhage occurred again and the patient died of hepatic failure. The postmortem examination revealed that the liver tumor had invaded the second portion of the duodenum and perforated into the lumen.
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