Hepatocellular carcinoma metastatic to the stomach presenting as bleeding multiple craterogenic ulcers

A patient with previous resection of primary hepatocellular carcinoma developed upper intestinal bleeding. Pinch biopsy and needle aspiration biopsy of a submucosal antral lesion seen at endoscopy yielded metastatic hepatoma. We believe this to be the first report of the endoscopic appearance of a submucosal tumor. Currently available methods of tissue diagnosis are discussed.