Fujii Kimihito, Nagino Masato, Kamiya Junichi, Uesaka Katsuhiko, Sano Tsuyoshi, Yuasa Norihiro, Oda Koji, Nimura Yuji
Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya 466-8550, Japan.
J Hepatobiliary Pancreat Surg. 2004;11(6):441-4. doi: 10.1007/s00534-004-0926-3.
A 61-year-old man presented with anemia (hemoglobin, 5.9 mg/dl) and a history of alcoholic liver disease. The patient also had a past history of a distal gastrectomy and Billroth II reconstruction, due to a gastric ulcer, performed 20 years previously. Endoscopic gastroscopy revealed a hemorrhagic ulcerative tumor at the gastrojejunostomy site. Computed tomography and angiography demonstrated a 10-cm tumor and a 2-cm tumor in the left lateral segment of the liver, suggestive of hepatocellular carcinoma (HCC). The larger tumor showed extrahepatic growth, with invasion of the stomach remnant. Because transcatheter arterial embolization of the tumor failed to control the bleeding, we carried out an en-bloc resection of the left lateral segment of the liver and the stomach remnant. Direct invasion of HCC into the gastrointestinal tract is rarely encountered. Here we report a case of HCC that invaded the stomach remnant and present a review of the literature.
一名61岁男性因贫血（血红蛋白5.9mg/dl）就诊，有酒精性肝病病史。该患者20年前因胃溃疡接受过远端胃切除术及毕Ⅱ式重建术。内镜胃镜检查发现胃空肠吻合口处有一个出血性溃疡性肿瘤。计算机断层扫描和血管造影显示肝脏左外叶有一个10cm的肿瘤和一个2cm的肿瘤，提示为肝细胞癌（HCC）。较大的肿瘤有肝外生长，侵犯了残留胃。由于经导管动脉栓塞术未能控制出血，我们对肝脏左外叶和残留胃进行了整块切除。肝细胞癌直接侵犯胃肠道的情况很少见。在此我们报告一例肝细胞癌侵犯残留胃的病例并对文献进行综述。
