Jejunal Metastasis from Hepatocellular Carcinoma

Area of Science:

• Gastroenterology
• Oncology
• Hepatology

Background:

• Hepatocellular carcinoma (HCC) is a primary liver cancer often associated with cirrhosis.
• Metastasis of HCC to the small intestine is rare but can present with obscure gastrointestinal bleeding.
• Standard endoscopic evaluations may fail to identify the bleeding source in such cases.

Observation:

• A 76-year-old male patient with a history of HCC and alcoholic cirrhosis presented with lightheadedness and melena.
• Previous upper and lower endoscopy did not reveal the source of bleeding.
• Oral double-balloon enteroscopy identified a jejunal mass, 20 cm distal to the ligament of Treitz.

Findings:

• Histopathological examination of the jejunal mass confirmed metastatic hepatocellular carcinoma.
• The jejunal lesion was identified as the source of the patient's gastrointestinal bleeding.
• This case highlights a rare presentation of HCC metastasis.

Implications:

• Double-balloon enteroscopy is a valuable tool for diagnosing obscure gastrointestinal bleeding, especially in patients with known malignancies.
• Early detection of small bowel metastasis from HCC can guide treatment strategies.
• Understanding rare metastatic patterns of HCC is essential for comprehensive patient management.