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Management of ruptured hepatocellular carcinoma invading the gastrointestinal tract: A case report
INTRODUCTION AND IMPORTANCE: Hepatocellular carcinoma (HCC) constitutes most of primary liver cancers. HCC invading the gastrointestinal tract (GIT) is considered a rare entity with limited reports in the literature. Management can either be palliative or curative such as transarterial chemoemboliza...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9284051/ https://www.ncbi.nlm.nih.gov/pubmed/35810682 http://dx.doi.org/10.1016/j.ijscr.2022.107330 |
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author | Hafez, Bassel Osman, Bassam Chami, Joelle Ahmad, Jana Haidar Ataya, Karim Khalife, Mohamad Jawad |
author_facet | Hafez, Bassel Osman, Bassam Chami, Joelle Ahmad, Jana Haidar Ataya, Karim Khalife, Mohamad Jawad |
author_sort | Hafez, Bassel |
collection | PubMed |
description | INTRODUCTION AND IMPORTANCE: Hepatocellular carcinoma (HCC) constitutes most of primary liver cancers. HCC invading the gastrointestinal tract (GIT) is considered a rare entity with limited reports in the literature. Management can either be palliative or curative such as transarterial chemoembolization (TACE) followed by definitive resection. Here, we present a case of direct HCC invasion of the GIT that was managed by surgical resection. CASE PRESENTATION: A 74-year-old male with a history of a liver mass, found to have HCC. Admitted for medical optimization prior to definitive resection, however his stay was complicated by hemorrhagic shock, with imaging findings of hemoperitoneum suggestive of spontaneous rupture of the mass. TACE was done to stabilize the patient prior to resection. Patient was taken immediately to the operating room for definitive resection. CLINICAL DISCUSSION: Most cases of direct HCC invasion into the GI tract present mainly with GI bleed. Some patients, present with abdominal pain without any warning signs of an occult GI bleed. Thus, absence of an occult GI bleeding does not exclude a GIT invasion. Management options are several, but in advanced stages, management is not limited to palliation. CONCLUSION: GIT invasion is a rare complication of HCC reported in scarcity in the literature. Most cases present with GI bleeding but with some rare cases, they present with more generalized symptoms like abdominal pain, weight loss or fatigue. Despite having a poor prognosis, complete surgical resection of the tumor may be a reassuring and life prolonging treatment option for these patients. |
format | Online Article Text |
id | pubmed-9284051 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-92840512022-07-16 Management of ruptured hepatocellular carcinoma invading the gastrointestinal tract: A case report Hafez, Bassel Osman, Bassam Chami, Joelle Ahmad, Jana Haidar Ataya, Karim Khalife, Mohamad Jawad Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Hepatocellular carcinoma (HCC) constitutes most of primary liver cancers. HCC invading the gastrointestinal tract (GIT) is considered a rare entity with limited reports in the literature. Management can either be palliative or curative such as transarterial chemoembolization (TACE) followed by definitive resection. Here, we present a case of direct HCC invasion of the GIT that was managed by surgical resection. CASE PRESENTATION: A 74-year-old male with a history of a liver mass, found to have HCC. Admitted for medical optimization prior to definitive resection, however his stay was complicated by hemorrhagic shock, with imaging findings of hemoperitoneum suggestive of spontaneous rupture of the mass. TACE was done to stabilize the patient prior to resection. Patient was taken immediately to the operating room for definitive resection. CLINICAL DISCUSSION: Most cases of direct HCC invasion into the GI tract present mainly with GI bleed. Some patients, present with abdominal pain without any warning signs of an occult GI bleed. Thus, absence of an occult GI bleeding does not exclude a GIT invasion. Management options are several, but in advanced stages, management is not limited to palliation. CONCLUSION: GIT invasion is a rare complication of HCC reported in scarcity in the literature. Most cases present with GI bleeding but with some rare cases, they present with more generalized symptoms like abdominal pain, weight loss or fatigue. Despite having a poor prognosis, complete surgical resection of the tumor may be a reassuring and life prolonging treatment option for these patients. Elsevier 2022-06-21 /pmc/articles/PMC9284051/ /pubmed/35810682 http://dx.doi.org/10.1016/j.ijscr.2022.107330 Text en © 2022 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Hafez, Bassel Osman, Bassam Chami, Joelle Ahmad, Jana Haidar Ataya, Karim Khalife, Mohamad Jawad Management of ruptured hepatocellular carcinoma invading the gastrointestinal tract: A case report |
title | Management of ruptured hepatocellular carcinoma invading the gastrointestinal tract: A case report |
title_full | Management of ruptured hepatocellular carcinoma invading the gastrointestinal tract: A case report |
title_fullStr | Management of ruptured hepatocellular carcinoma invading the gastrointestinal tract: A case report |
title_full_unstemmed | Management of ruptured hepatocellular carcinoma invading the gastrointestinal tract: A case report |
title_short | Management of ruptured hepatocellular carcinoma invading the gastrointestinal tract: A case report |
title_sort | management of ruptured hepatocellular carcinoma invading the gastrointestinal tract: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9284051/ https://www.ncbi.nlm.nih.gov/pubmed/35810682 http://dx.doi.org/10.1016/j.ijscr.2022.107330 |
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