Direct duodenal invasion of hepatocellular carcinoma. Intestinal hemorrhage treated by transcatheter arterial embolization.

This report describes a case of direct duodenal invasion of hepatocellular carcinoma with massive intermittent gastrointestinal (GI) bleeding. Progressive anemia was intractable by supportive therapy alone, and repeated blood transfusion was necessary. Transcatheter arterial embolization was finally carried out, which dramatically reduced the amount of transfusion. Owing to severe blood loss, patients with GI tract involvement generally have a poor prognosis.