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Abstract

ABSTRACT: vascular stalk and is easily resected without sacrifice of significant amount of non-neoplastic liver tissue (1). BACKGROUND: Pedunculated type is a rare macroscopical form of hepatocellular carcinoma. THE IRAQI POSTGRADUATE MEDICAL JOURNAL VOL.7, NO. 2, 2008 CASE REPORT: 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. CASE REPORT : CONCLUSION: 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.

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