Intractable bleeding from solitary mandibular metastasis of hepatocellular carcinoma

作     者：Shiang-Fu Huang Ren-Chin Wu Joseph Tung-Chieh Chang Sheng-Chieh Chan Chun-Ta Liao I-How Chen Chun-Nan Yeh 

作者机构：Department of Otolaryngology Chang Oung Memorial Hospital Chang Oung University Linkou Taiwan China Department of Anatomic Pathology Chang Gung Memorial Hospital Chang Gung University Linkou Taiwan China Department of Radiation Oncology Chang Gung Memorial Hospital Chang Gung University Linkou Taiwan China Department of Nuclear Medicine Chang Gung Memorial Hospital Chang Gung University Linkou Taiwan China Department of General Surgery Chang Gung Memorial Hospital Chang Gung University Linkou Taiwan China 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2007年第13卷第33期

页      面：4526-4528页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Hepatocelluar carcinoma Metastasis Mandible Radiotherapy Bleeding 

摘      要：Hepatocellular carcinoma （HCC） metastasizes to the mandible is infrequently seen. Solitary bony metastasis to the mandible is rarer. The intractable bleeding caused by rupture of the metastatic HCC is challenging to clinicians. We present a case of a 74-year-old woman with HCC under control without progression for 3 years. Left facial swelling and episodes of bleeding developed recently and biopsy revealed a metastatic HCC. Computer tomography showed a large tumor in parapharyngeal space with evident mandibular ramus destruction. Bleeding occurred from the metastatic tumor but could not be controlled by electrocauterization, SurgicelTM, tissue glue, and bone wax and angiographic embolization. Palliative radiotherapy （2400 cGy in 6 fractions） was tried and the intractable bleeding was successfully stopped after the radiotherapy. Because of the hypervascular and osteolytic nature of the solitary mandibular metastatic lesion, the bleeding was troublesome. Radiotherapy provided successful control of intractable bleeding from the metastatic tumor.