Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jul 28, 2008; 14(28): 4583-4585
Published online Jul 28, 2008. doi: 10.3748/wjg.14.4583
Direct invasion to the colon by hepatocellular carcinoma: Report of two cases
Teijiro Hirashita, Masayuki Ohta, Kentaro Iwaki, Seiichiro Kai, Kohei Shibata, Atsushi Sasaki, Kimihiro Nakashima, Seigo Kitano
Teijiro Hirashita, Masayuki Ohta, Kentaro Iwaki, Seiichiro Kai, Kohei Shibata, Seigo Kitano, Department of Surgery I, Oita University Faculty of Medicine, Oita 879-5593, Japan
Atsushi Sasaki, Department of Surgery, Miyazaki National Hospital, Miyazaki 889-1301, Japan
Kimihiro Nakashima, Department of Surgery, Sakai Hospital, Oita 871-0024, Japan
Author contributions: Hirashita T, Kai S, Shibata K, Sasaki A, and Nakashima K were involved in the treatment of these patients; Iwaki K contributed to the pathological examination; Hirashita T, Ohta M, and Kitano S wrote the paper.
Correspondence to: Teijiro Hirashita, MD, Department of Surgery I, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yuhu, Oita 879-5593, Japan. teij01@ray.ocn.ne.jp
Telephone: +81-97-586-5843
Fax: +81-97-549-6039
Received: May 1, 2008
Revised: June 10, 2008
Accepted: June 17, 2008
Published online: July 28, 2008
Abstract

Although hepatocellular carcinoma (HCC) is a common tumor, direct invasion of the gastrointestinal tract by HCC is uncommon. Recently, we encountered two cases of HCC with direct invasion to the colon. The first patient was a 79-year-old man who underwent transarterial chemo-embolization (TACE) for HCC 1.5 years prior to admission to our hospital. Computed tomography (CT) showed a 7.5-cm liver tumor directly invading the transverse colon. Partial resection of the liver and transverse colon was performed. The patient survived 6 mo after surgery, but died of recurrent HCC. The second patient was a 69-year-old man who underwent TACE and ablation for HCC 2 years and 7 months prior to being admitted to our hospital for melena and abdominal distension. CT revealed a 6-cm liver tumor with direct invasion to the colon. The patient underwent partial resection of the liver and right hemicolectomy. The patient recovered from the surgery. But, unfortunately, he died of liver failure due to liver cirrhosis one month later. Although the prognosis of HCC that has invaded the colon is generally poor due to the advanced stage of the disease, surgical resection may be a favorable treatment option in patients with a good general condition.

Keywords: Hepatocellular carcinoma; Colon; Hepatoma