간세포암의 직접 위 침윤에 의한 상부 위장관 출혈 1예
A Case of a Patient Presenting with Upper Gastrointestinal Bleeding Due to Direct Stomach Invasion by Hepatocellular Carcinoma
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초록
간세포암 환자에게 상부 위장관 출혈이 있을 때 흔히 식도 및 위 정맥류 출혈과 궤양 출혈이 원인이나 드물게 위장관 전이에 의해서도 발생한다. 저자들은 과거 상부 위장관 내시경검사에서 외부 압박의 소견을 보이는 간 좌엽의 간세포암 환자가 간동맥 화학색전술을 시행한 후 토혈과 흑색변을 주소로 내원하여 상부 위장관 내시경에서 발견된 종괴에 대한 조직검사와 복부 전산화 단층촬영을 시행하여 간세포암이 위체부로 직접 침윤하여 일으킨 상부위장관 출혈 1예를 경험하여 문헌 고찰과 함께 보고한다.
Abstract
Gastrointestinal bleeding is a common complication of hepatocellular carcinoma, and the most common causes are esophageal varix, gastric varix and a bleeding ulcer. Hepatocellular carcinoma rarely invades the gastrointestinal tract, and this has been shown to occur in 0.7∼2% of the clinical hepatocellular carcinoma cases. A 52-year old male who had a history of a huge hepatocellular carcinoma on the left lobe of the liver and this had been by chemoembolization was admitted due to hematemesis and melena. Esophagogastroduodenoscopy showed a huge fungating mass with easy contact bleeding in the lesser curvature of the gastric body. The histology was consistent with the diagnosis of metastatic hepatocellular carcinoma and results of the CT scan supported this finding. This case illustrates a rare event of direct invasion of hepatocellular carcinoma into the stomach and this was followed by gastrointestinal hemorrhage.
참고문헌 (14)
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