Hepatoma presenting as lower gastrointestinal bleeding.

A 61-year old white male, known to have alcoholic cirrhosis, presented with massive fresh bleeding per rectum. Various investigations failed to ascertain the cause of bleeding. Hepatoma of the liver was revealed by selective hepatic and superior mesenteric angiography. Massive lower gastrointestinal bleeding occurred again one month later and was rapidly followed by death from hepatic coma. An extensive hepatoma infiltrating the adjacent hepatic flexure of the colon was found at autopsy, the colonic infiltration explaining the lower gastrointestinal hemorrhage.