Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2019; 7(15): 2044-2048
Published online Aug 6, 2019. doi: 10.12998/wjcc.v7.i15.2044
Left colonic metastasis from primary hepatocellular carcinoma: A case report
Fulvio Tagliabue, Morena Burati, Marco Chiarelli, Alessandro Marando, Matilde De Simone, Ugo Cioffi
Fulvio Tagliabue, Morena Burati, Marco Chiarelli, Department of Emergency and Robotic Surgery, Ospedale “A Manzoni” Lecco via Dell’Eremo 9/11, Lecco 23900, Italy
Alessandro Marando, Department of Pathology, Ospedale “A Manzoni” Lecco via Dell’Eremo 9/11, Lecco 23900, Italy
Matilde De Simone, Ugo Cioffi, Department of Surgery, University of Milan, Milano 20122, Italy
Author contributions: Tagliabue F performed the operation and contributed to manuscript drafting; Burati M reviewed the literature and contributed to manuscript drafting; Marando A performed the microbiological analyses and interpretation and contributed to manuscript drafting; Chiarelli M, Simone MD and Cioffi U reviewed the literature and drafted the manuscript; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ugo Cioffi, MD, PhD, Full Professor, Professor, Surgeon, Department of Surgery, University of Milan, Via F Sforza 35, Milano 20122, Italy. ugo.cioffi@guest.unimi.it
Telephone: +39-341-253331 Fax: +39-341-489311
Received: April 17, 2019
Peer-review started: April 19, 2019
First decision: June 21, 2019
Revised: June 29, 2019
Accepted: July 20, 2019
Article in press: July 20, 2019
Published online: August 6, 2019
Abstract
BACKGROUND

Hepatocellular carcinoma (HCC) accounts for 5-6% of all human cancers. Considering the extrahepatic metastasis, the main organs involved are lymphnodes, lung, bone and adrenal gland. Usually colon metastasis is very rare, especially on the left sided colon.

CASE SUMMARY

We report a case of a 70 years-old man hepatitis B carrier with HCC treated four times with trans-arterial chemoembolization, presented to our surgical department complaining of gastrointestinal bleeding. A colonoscopy revealed a mass of 4 cm of the sigmoid colon with signs of bleeding. The computed tomography showed a mass originated from the sigmoid colon of 3.5 cm, and the presence of HCC in segment VI and VII, without portal vein thrombosis. Due to the large size of the mass and the active bleeding, the patient underwent a left colectomy. The postoperative period was uneventful, and the patient was discharged in fifth post-operative day. Histological examination revealed that the neoplasm was characterized by a diffuse proliferation of epithelial cells with an hepatoid differentiation. So, the presence of a history of HCC of the liver and the histopathological features supported the diagnosis of metastasis from the liver.

CONCLUSION

Although rare, colon metastasis from an HCC can be left-sided and can present with acute bleeding.

Keywords: Hepatocellular carcinoma, Colon metastasis, Case report

Core tip: Colon metastasis from hepatocellular carcinoma are extremely rare and, when present, they usually located in the right colon. We present a case of a left sided colon metastasis, which presented with acute bleeding and anemia for which the patient underwent left hemicolectomy.