Li L, Zhang W H, Meng F P, Ma X M, Shen L J, Jin B, Li H W, Han J, Zhou G D, Liu S H
Liver Cirrhosis Treatment Center, 302 Military Hospital of China, Beijing, China.
Liver Cirrhosis Treatment Center, 302 Military Hospital of China, Beijing, China.
Transplant Proc. 2015 Oct;47(8):2544-7. doi: 10.1016/j.transproceed.2015.09.012.
Gastrointestinal (GI) metastasis of hepatocellular carcinoma is very rare. This is the first report of post-transplantation gastric metastasis. A 43-year-old man with a history of hepatitis B-related hepatocellular carcinoma (HCC) in the right anterior segment of the liver received an orthotopic liver transplant. Three months after the transplantation, pulmonary metastasis was found by chest computed tomography, and he received 1 course of gamma knife treatment. He complained of melena with anemia 17 months post liver transplantation. Abdominal CT scan showed new occupying lesions in the liver and a mass in the stomach and around the spleen with embolus in the splenic vein. Endoscopy revealed a large irregular cauliflower-like mass in fundus with ulceration and bleeding on the surface. He received symptomatic treatment, but died of cancer-related bleeding 4 months later. GI bleeding may due to gastric metastasis after liver transplantation.
肝细胞癌的胃肠道转移非常罕见。这是第一例肝移植术后胃转移的报告。一名43岁男性，有乙肝相关肝细胞癌病史，肿瘤位于肝右前叶，接受了原位肝移植。移植后三个月，胸部计算机断层扫描发现肺转移，随后接受了1个疗程的伽马刀治疗。肝移植17个月后，他出现黑便伴贫血。腹部CT扫描显示肝脏有新的占位性病变，胃和脾周围有肿块，脾静脉有栓子。内镜检查发现胃底部有一个大的不规则菜花状肿块，表面有溃疡和出血。他接受了对症治疗，但4个月后死于癌症相关出血。肝移植后胃肠道出血可能是由于胃转移所致。
