A Case of Hepatocellular Carcinoma Invading the Duodenum Directly

Michiya Kobayashi, Takuro Ogata, Akira Keneko, Shinichi Hamada, Kimio Matsuura, Keijiro Araki

First Department of Surgery, Kochi Medical School

We experienced a case of hepatocellular carcinoma invading the duodenal bulb, which was diagnosed by endoscopic biopsy. A 47-year-old man was transferred to our hospital with the diagnosis of duodenal leiomyosarcoma with multiple liver metastasis by barium meal examination and abdominal CT. In addition to positive HBsAg, a high level of serum AFP and the angiography findings, endoscopic biopsy revealed Edmondson type 3 hepatocellular carcinoma. Laparotomy was performed because of duodenal bleeding. He died of hepatic failure 38 days after the operation. Autopsy revealed the primary lesion in the left lobe of the liver with multiple intrahepatic metastases. The tumor invaded the duodenal bulb directly through a fistula. We reviewed the 10 reported cases of hepatoma in Japan with invasion or metastasis to the duodenum.

Key words
hepatoma, duodenal invasion of hepatoma, metastasis of hepatoma to the duodenum

Reprint requests
Michiya Kobayashi First Department of Surgery, Kochi Medical School
Oko-cho, Nankoku, 783 JAPAN

Accepted
June 17, 1992

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