Year 2024 / Volume 116 / Number 8
Letter
Hepatic invasion of a gastric ulcer confirmed by endoscopy and surgery

457

DOI: 10.17235/reed.2023.9999/2023

Ikuhiro Kobori, Takashi Mitsui, Kazuma Sakakibara, Kazuyuki Saito, Koichi Soga, Yasumi Katayama, Shinichi Ban, Masaya Tamano,

Abstract
A 66-year-old woman who had been suffering from chronic anorexia for two years was transported to the hospital after being unable to consume food for three days. She had no hematemesis or abdominal pain and had no history of taking nonsteroidal anti-inflammatory drugs. Blood tests showed marked anemia with hemoglobin of 3.3 g/dL, and esophagogastroduodenoscopy revealed a large ulcer lesion in the lesser curvature of the gastric body and a liver-like mass protruding from the ulcer base. Biopsy of the mass showed proliferation of cells showing irregular cord-like structures, suggestive of normal liver tissue or hepatocellular carcinoma. Computed tomography scan showed no obvious free air in the abdomen. Despite conservative treatment, the patient developed hematemesis and progressive anemia, and surgery was performed (total gastrectomy with partial hepatectomy). Surgical specimen showed an ulcer lesion with fibrosis and loss of wall structure in all layers of the stomach, and liver adhesion with fibrosis deep in the ulcer, but no malignant findings. With the advent of powerful gastric acid secretion inhibitors, gastric ulcer invasion into the liver is now very rare, and this case is thus a valuable example showing very clear images.
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References
1. Kayacetin E, Kayacetin S. Gastric ulcer penetrating to liver diagnosed by endoscopic biopsy. World J Gastroenterol 2004;10:1838-40. doi: 10.3748/wjg.v10.i12.1838
2. Stylianopoulou L, Bartsokas C, Kalliakmanis V. Gastric ulcer penetration into liver: A case presentation and review of the literature. Clin Case Rep. 2020;9:282-5. doi: 10.1002/ccr3.3515
3. Dias E, Cardoso H, Costa C, et al. Gastric ulcer with liver penetration. Rev Esp Enferm Dig. 2022;114:248-9. doi: 10.17235/reed.2022.8528/2021
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Kobori I, Mitsui T, Sakakibara K, Saito K, Soga K, Katayama Y, et all. Hepatic invasion of a gastric ulcer confirmed by endoscopy and surgery. 9999/2023


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Publication history

Received: 05/10/2023

Accepted: 10/10/2023

Online First: 26/10/2023

Published: 01/08/2024

Article Online First time: 21 days

Article editing time: 301 days


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