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Gastric metastasis of recurrent hepatocellular carcinoma: A case report and literature review

Hepatocellular carcinoma (HCC) with gastric metastasis is seldom reported. It is extremely easy to misdiagnose for primary gastric cancer with liver metastasis, especially gastric hepatoid adenocarcinoma. Here, we report a case of recurrent HCC with gastric metastasis in a 22-year-old man. He had a history of left side hepatic tumor local resection due to ruptured HCC 10 years ago. Computed tomography revealed tumors in the right liver and stomach. Endoscopy identified a massive protrusion-like malignant stromal tumor at the greater curvature of gastric body. Curative resection was performed, and HCC with gastric metastasis was diagnosed by histological and immunohistochemical findings. The patient received two times of chemotherapy and remained tumor free for 15 months. Previous studies and our experience suggested that surgical resection could significantly prolong the survival and improve patients' quality of life. A brief literature review was conducted to elucidate the differential diagnosis and treatment of HCC with gastric metastasis.