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- W830142510 abstract "∗ Corresponding author. E-mail address: rosacoelhoabrantes@hotmail.com (R. Coelho). Emergency Department, nine months after, with melenic stool and epigastric pain, the laboratory work-up revealed hemoglobin 6.5 g/dL with MCV of 72.3 fl. Esophagogastroduodenoscopy was performed and revealed in the anterior and superior bulb wall, protruding into the duodenal lumen, a dark reddish polypoid lesion with 30 mm of maximum diameter that occluded half of the lumen (Fig. 1). Biopsies were taken as it was not actively bleeding at the time of endoscopy. Histological analysis showed a fibrin clot with hepatic phenotype cells in the peripheral area. These cells showed cytological atypia and were disaggregated (Fig. 2A). Immunohistochemical studies revealed positive tumor cells staining for Heppar-1 (Fig. 2B), HSP-70 (Fig. 2C) and glutamine synthetize (Fig. 2D). Immunostaining showed negative results for CDX-2 and glipican-3, confirming the diagnosis of locally advanced HCC. Abdominopelvic CT was performed and showed multiple liver masses located in the left hepatic lobe, with the confluent lesions measuring 19.9 cm of maximum diameter, some of them occupied the right lobe (Fig. 3A). It was also possible to recognize evidence of local invasion of the first part of the duodenum (Fig. 3B). Supportive treatment was given and the patient died of hepatic coma three weeks after the episode of gastrointestinal bleeding." @default.
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- W830142510 date "2015-07-01" @default.
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- W830142510 title "Upper Gastrointestinal Hemorrhage as an Unexpected Feature of Hepatocellular Carcinoma" @default.
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- W830142510 doi "https://doi.org/10.1016/j.jpge.2015.03.007" @default.
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