A Case of Hepatocellular Carcinoma With Solitary Metastatic Gastric Carcinoma

A 78-year-old man with history of hepatitis B infection was detected to have an abnormal liver function during his physical examination. After a close examination at our hospital, he diagnosed hepatocellular carcinoma. The patient initially treated transcatheter arterial chemoembolization, but due allergy contrast media, it became difficult continue the treatment, and sorafenib. Seven months after initiation sorafenib, lung metastasis detected. He regorafenib cabozantinib, metastatic tumor increased in size. Immediately atezolizumab bevacizumab combination therapy, had melena emergency esophagogastroduodenoscopy revealing duodenal ulcer, which hemostasis. At that time, there were no other lesions could been cause bleeding. 11 continued treatment without ulcer recurrence, again anemia. Esophagogastroduodenoscopy revealed elevated lesion approximately 2 cm size upper gastric antrum (Figures A–C). Immunostaining biopsy pathology showed Hep-par 1 positive, Glypican-3 Arginase-1 positive (Figure D), led diagnosis carcinoma metastasis. is currently undergoing palliative radiotherapy for purpose hemostasis persistent anemia requiring blood transfusion.