Keywords : pedunculated

Intestinal Perforation of Pedunculated Hepatocellular Carcinoma CASEREPORT (Rare among rarities)

Raafat Roof Ahmed

Iraqi Postgraduate Medical Journal, 2008, Volume 7, Issue 2, Pages 187-191

vascular stalk and is easily resected without sacrifice of significant amount of non-neoplastic liver tissue (1).
Pedunculated type is a rare macroscopical form of hepatocellular carcinoma. THE IRAQI POSTGRADUATE MEDICAL JOURNAL VOL.7, NO. 2, 2008
47 years old male complained from vague abdominal pain, anorexia, weight loss and malena during the last few months. Abdominal ultrasound and spiral CT scan revealed a vascular mass 17x13 cm. in diameter occupying the whole right side of the abdomen. On exploration the mass was perforated into a segment of ileum due to direct invasion and attached to the liver by vascular pedicle. The mass was completely excised with segment of ileum followed by end-end anastomosis. Immunohistochemical study shows that the tumor was stained by alpha-fetoprotein staining confirming the diagnosis of pedunculated hepatocellular carcinoma.
This is a case report of pedunculated HCC which perforated into small bowel causing severe bleeding per rectum, to highlight the importance of this rare and potentially curative disease.
pedunculated hepatocellular carcinoma should be kept in mind in any differential diagnosis of large intraperitoneal mass even if it is not related to the liver by imagining study.