Summary
Gastrointestinal tract involvement with hepatocellular carcinoma was observed in 8
out of 396 patients (2 %) during the course of the disease. Histological involvement
was confirmed in 6 cases. All 8 patients were men. The most common clinical presentation
was frank gastrointestinal bleeding, which became evident in all cases. Esophageal
varices were not seen in any patient. The sites of involvement were the stomach (3),
duodenum (4), and jejunum (1). The median time between the diagnosis of primary tumors
and gastrointestinal tract involvement was 4.5 months (range: 0 to 12 months). Hematogenous
spread was presumed to have occurred in two patients with diffuse-type hepatocellular
carcinoma, one of whom had main portal vein thrombosis. Direct invasion by contiguous
neoplasm was the major mode of gastrointestinal tract involvement. This complication
is more likely to develop in patients with large, subcapsular. massive type hepatocellular
carcinoma treated by transcatheter arterial embolization and/or intra-arterial chemotherapy.
The median survival after the diagnosis of gastrointestinal involvement was 1 month
(2 weeks-4 months).
Key words:
Hepatocellular carcinoma - Gastrointestinal tract involvement - Hematogenous spread
- Direct invasion
