Metastasis of hepatocellular carcinoma to the small bowel manifested by intussusception

Figure 1 Plain radiography of abdomen showed stepladder appearance.

Figure 2 Computed tomography scan showed a “target mass” lesion (arrow) in the right lower abdomen, representing the intussuscepted mesenteric fat and vessel.

Figure 3 Abdominal ultrasound showed, A: “pseudo kidney sign” at the body of intussusception, B: Lobulated mass lesion at the head of intussusception, which was suspected of leading point of intussusception.

Figure 4 Surgical specimen showed that mass arising from submucosa grown into lumen and had dimpling portion on the top of tumor.

Figure 5 Histological examination demonstrated a poorly differentiated adenocarcinoma with hepatoid feature of trabecular pattern (HE X 100).

Figure 6 Strongly positive staining for alpha-fetoprotein and cytokeratin 18 (Immunoperoxidase × 100).