Abstract
BackgroundHepatocellular carcinoma (HCC) is a malignant tumor with frequent intrahepatic metastases; extrahepatic metastases are not rare but less frequent compared to intrahepatic ones. The most frequent sites of extrahepatic metastases are the lungs, followed by the lymph nodes, bones, and adrenal glands. Case report covering gastrointestinal (GI) tract involvement from HCC is limited.Case presentationA 60-year-old man was referred to us in May 2019 with a diagnosis of sigmoid colon tumor. The patient had a history of HCC and had received two stages of open resections for the primary and the abdominal metastasis successively and many times of transcatheter arterial chemoembolization (TACE). The sigmoid colon tumor received Hartmann procedure after abdominal enhanced computerized tomography (CT) scan and colonoscopy, while postoperative pathology and immunohistochemistry identified it as extrahepatic colonic metastasis from HCC.ConclusionsThe ratio of extrahepatic metastasis to the digestive tract was very low, and the majority was upper gastrointestinal involvement because of direct invasion or intraperitoneal implantation. TACE may be the risk factor of retrograde hematogenous metastasis to the downstream colon.KeywordsHepatocellular carcinoma; Extrahepatic metastases; Colon metastasis; Transcatheter arterial chemoembolization
Highlights
Hepatocellular carcinoma (HCC) is a malignant tumor with frequent intrahepatic metastases; extrahepatic metastases are not rare but less frequent compared to intrahepatic ones
With the largest population of hepatitis B infections, China has the greatest number of primary liver cancer, and the incidence rate is 26.67/100,000; that is over 373,000 new cases per year, of which 80% are HCC [1]
We report a rare case of extrahepatic metastasis of the colon from HCC and review the related literature on the disease
Summary
Patients who have had a history of HCC with high AFP level initially diagnosed with colorectal cancer should be considered extrahepatic metastases from HCC as well. Intraperitoneal implantation, and hematogenous metastasis are the most possible ways for the tumor to spread. TACE/TAE will raise the portal venous pressure, which may cause retrograde hematogenous metastases to the downstream colon. Though HCC patients with colon metastasis have very poor prognosis, surgery is an effective way to relieve the symptoms and prolong overall survival
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
