Korkolis DP, Aggeli C, Plataniotis GD, Gontikakis E, Zerbinis H, Papantoniou N, Xinopoulos D, Apostolikas N, Vassilopoulos PP. Successful en bloc resection of primary hepatocellular carcinoma directly invading the stomach and pancreas. World J Gastroenterol 2009; 15(9): 1134-1137 [PMID: 19266609 DOI: 10.3748/wjg.15.1134]
Corresponding Author of This Article
Dimitris P Korkolis, MD, PhD, Department of Surgical Oncology, Hellenic Anticancer Institute, “Saint Savvas” Hospital, 22 Socratous Street, 1st Floor, Kifissia, Athens 14561, Greece. dkorkolis_2000@yahoo.com
Article-Type of This Article
Case Report
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World J Gastroenterol. Mar 7, 2009; 15(9): 1134-1137 Published online Mar 7, 2009. doi: 10.3748/wjg.15.1134
Successful en bloc resection of primary hepatocellular carcinoma directly invading the stomach and pancreas
Dimitris P Korkolis, Chrysanthi Aggeli, George D Plataniotis, Emmanuel Gontikakis, Helen Zerbinis, Nikitas Papantoniou, Dimitris Xinopoulos, Nikiforos Apostolikas, Perikles P Vassilopoulos
Dimitris P Korkolis, Chrysanthi Aggeli, George D Plataniotis, Emmanuel Gontikakis, Helen Zerbinis, Perikles P Vassilopoulos, Department of Surgical Oncology, Hellenic Anticancer Institute, “Saint Savvas” Hospital, Athens 14561, Greece
Nikitas Papantoniou, Dimitris Xinopoulos, Department of Gastroenterology, Hellenic Anticancer Institute, “Saint Savvas” Hospital, Athens 14561, Greece
Nikiforos Apostolikas, Department of Surgical Pathology, Hellenic Anticancer Institute, “Saint Savvas” Hospital, Athens 14561, Greece
Author contributions: Korkolis DP designed the research; Korkolis DP, Aggeli C, Plataniotis GD, Gontikakis E, Zerbinis H, Vassilopoulos PP performed the research; Apostolikas N performed the data analysis; Papantoniou N and Xinopoulos D contributed to the interpretation of data.
Correspondence to: Dimitris P Korkolis, MD, PhD, Department of Surgical Oncology, Hellenic Anticancer Institute, “Saint Savvas” Hospital, 22 Socratous Street, 1st Floor, Kifissia, Athens 14561, Greece. dkorkolis_2000@yahoo.com
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Received: September 16, 2008 Revised: October 10, 2008 Accepted: October 17, 2008 Published online: March 7, 2009
Abstract
Multivisceral surgical resection for cure was successfully performed in a 70-year-old man suffering from a primary hepatocellular carcinoma (HCC) associated with direct invasion to the stomach and pancreas. The patient presented with gastric outlet obstruction, upper abdominal pain and a history of chronic liver disease due to hepatitis B virus (HBV) infection. Upper gastrointestinal (GI) endoscopy revealed an infiltrating tumor protruding through the gastric wall and obliterating the lumen. Computer tomograghy (CT) and magnetic resonance imaging (MRI) scan demonstrated a 15-cm tumor in the left lateral segment of the liver with invasion to the stomach and pancreas. Alpha-foetoprotein (AFP) levels and liver function tests were normal. The patient underwent an en bloc left hepatectomy, total gastrectomy, distal pancreatectomy with splenectomy and radical lymphadenectomy. Pathology revealed a poorly differentiated, giant cell HCC involving the stomach and pancreas. Disease-free margins of resection were achieved. The patient’s postoperative course was uneventful. Sixteen months after surgery, he has no recurrence or distal metastasis. Direct invasion of HCC into the GI tract is rarely encountered. Complete surgical resection should be considered in selected patients with an appropriate hepatic functional reserve.
