The Association Between Hepatocellular Carcinoma and Gastrointestinal Adenocarcinoma: Is This a New Syndrome in Patients With Cirrhosis? A Case Series

ABSTRACT Aim This case series aimed to explore the occurrence of synchronous hepatocellular carcinoma (HCC) and gastrointestinal adenocarcinoma in cirrhotic patients and to propose a potential common pathogenic mechanism. Cases We reviewed the available literature and retrospectively analyzed seven...

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Main Authors: Fabrizio Bronte, Fabio D'Amato, Maria Rosa Barcellona, Giuseppe Bronte, Giuseppe Malizia, Salvatore Ialuna, Giorgio Fusco, Francesco Verderame, Enrico Bronte, Maria Grazia Bavetta
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Language:English
Published: Wiley 2025-05-01
Series:Cancer Reports
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Online Access:https://doi.org/10.1002/cnr2.70182
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author Fabrizio Bronte
Fabio D'Amato
Maria Rosa Barcellona
Giuseppe Bronte
Giuseppe Malizia
Salvatore Ialuna
Giorgio Fusco
Francesco Verderame
Enrico Bronte
Maria Grazia Bavetta
author_facet Fabrizio Bronte
Fabio D'Amato
Maria Rosa Barcellona
Giuseppe Bronte
Giuseppe Malizia
Salvatore Ialuna
Giorgio Fusco
Francesco Verderame
Enrico Bronte
Maria Grazia Bavetta
author_sort Fabrizio Bronte
collection DOAJ
description ABSTRACT Aim This case series aimed to explore the occurrence of synchronous hepatocellular carcinoma (HCC) and gastrointestinal adenocarcinoma in cirrhotic patients and to propose a potential common pathogenic mechanism. Cases We reviewed the available literature and retrospectively analyzed seven cases of cirrhotic patients with synchronous HCC and gastrointestinal adenocarcinoma (colon or gastric) identified in our center between March 2020 and June 2023. All patients underwent upper gastrointestinal endoscopy, abdominal ultrasound, computed tomography (CT) scan, and histological confirmation through biopsy or surgery. The mean age of the patients was 77.3 years (range 76–83), with five males and two females. Five patients had liver cirrhosis, and two had chronic hepatitis (one with HCV, one with MASLD). HCC was confirmed in all patients, with elevated alpha‐fetoprotein levels (mean: 737.6 ng/mL). Colon adenocarcinoma was found in five patients, and gastric adenocarcinoma in one patient. Genetic and microsatellite instability analyses were performed in selected cases, revealing high microsatellite instability in one patient. We suggest that the Wnt/APC/β‐catenin pathway might play a key role in the pathogenesis of both HCC and gastrointestinal malignancies. Conclusions Synchronous HCC and gastrointestinal adenocarcinoma may be increasingly identified due to prolonged survival in cirrhotic patients. Alterations in the Wnt/APC/β‐catenin pathway could represent a shared pathogenic mechanism. Regular surveillance through ultrasound and endoscopy is essential for early diagnosis in this high‐risk population. Future research is needed to confirm these findings and explore targeted treatments.
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spelling doaj-art-1b68e64c59054d45bfe0dc276589b6402025-08-20T02:30:23ZengWileyCancer Reports2573-83482025-05-0185n/an/a10.1002/cnr2.70182The Association Between Hepatocellular Carcinoma and Gastrointestinal Adenocarcinoma: Is This a New Syndrome in Patients With Cirrhosis? A Case SeriesFabrizio Bronte0Fabio D'Amato1Maria Rosa Barcellona2Giuseppe Bronte3Giuseppe Malizia4Salvatore Ialuna5Giorgio Fusco6Francesco Verderame7Enrico Bronte8Maria Grazia Bavetta9Gastroenterology Unit Ospedali Riuniti Villa Sofia – V. Cervello Palermo ItalyInterventional Radiology and Neuroradiology Unit Ospedali Riuniti Villa Sofia – V. Cervello Palermo ItalyHepatOncology Unit Ospedali Riuniti Villa Sofia – V. Cervello Palermo ItalyDepartment of Translational Medicine University of Ferrara Ferrara ItalyGastroenterology Unit Ospedali Riuniti Villa Sofia – V. Cervello Palermo ItalyNuclear Medicine Unit Ospedali Riuniti Villa Sofia – V. Cervello Palermo ItalyHepatOncology Unit Ospedali Riuniti Villa Sofia – V. Cervello Palermo ItalyOncology Unit Ospedali Riuniti Villa Sofia – V. Cervello Palermo ItalyOncology Unit Ospedali Riuniti Villa Sofia – V. Cervello Palermo ItalyHepatOncology Unit Ospedali Riuniti Villa Sofia – V. Cervello Palermo ItalyABSTRACT Aim This case series aimed to explore the occurrence of synchronous hepatocellular carcinoma (HCC) and gastrointestinal adenocarcinoma in cirrhotic patients and to propose a potential common pathogenic mechanism. Cases We reviewed the available literature and retrospectively analyzed seven cases of cirrhotic patients with synchronous HCC and gastrointestinal adenocarcinoma (colon or gastric) identified in our center between March 2020 and June 2023. All patients underwent upper gastrointestinal endoscopy, abdominal ultrasound, computed tomography (CT) scan, and histological confirmation through biopsy or surgery. The mean age of the patients was 77.3 years (range 76–83), with five males and two females. Five patients had liver cirrhosis, and two had chronic hepatitis (one with HCV, one with MASLD). HCC was confirmed in all patients, with elevated alpha‐fetoprotein levels (mean: 737.6 ng/mL). Colon adenocarcinoma was found in five patients, and gastric adenocarcinoma in one patient. Genetic and microsatellite instability analyses were performed in selected cases, revealing high microsatellite instability in one patient. We suggest that the Wnt/APC/β‐catenin pathway might play a key role in the pathogenesis of both HCC and gastrointestinal malignancies. Conclusions Synchronous HCC and gastrointestinal adenocarcinoma may be increasingly identified due to prolonged survival in cirrhotic patients. Alterations in the Wnt/APC/β‐catenin pathway could represent a shared pathogenic mechanism. Regular surveillance through ultrasound and endoscopy is essential for early diagnosis in this high‐risk population. Future research is needed to confirm these findings and explore targeted treatments.https://doi.org/10.1002/cnr2.70182adenocarcinomacirrhosisgastrointestinalhepatocellular carcinoma
spellingShingle Fabrizio Bronte
Fabio D'Amato
Maria Rosa Barcellona
Giuseppe Bronte
Giuseppe Malizia
Salvatore Ialuna
Giorgio Fusco
Francesco Verderame
Enrico Bronte
Maria Grazia Bavetta
The Association Between Hepatocellular Carcinoma and Gastrointestinal Adenocarcinoma: Is This a New Syndrome in Patients With Cirrhosis? A Case Series
Cancer Reports
adenocarcinoma
cirrhosis
gastrointestinal
hepatocellular carcinoma
title The Association Between Hepatocellular Carcinoma and Gastrointestinal Adenocarcinoma: Is This a New Syndrome in Patients With Cirrhosis? A Case Series
title_full The Association Between Hepatocellular Carcinoma and Gastrointestinal Adenocarcinoma: Is This a New Syndrome in Patients With Cirrhosis? A Case Series
title_fullStr The Association Between Hepatocellular Carcinoma and Gastrointestinal Adenocarcinoma: Is This a New Syndrome in Patients With Cirrhosis? A Case Series
title_full_unstemmed The Association Between Hepatocellular Carcinoma and Gastrointestinal Adenocarcinoma: Is This a New Syndrome in Patients With Cirrhosis? A Case Series
title_short The Association Between Hepatocellular Carcinoma and Gastrointestinal Adenocarcinoma: Is This a New Syndrome in Patients With Cirrhosis? A Case Series
title_sort association between hepatocellular carcinoma and gastrointestinal adenocarcinoma is this a new syndrome in patients with cirrhosis a case series
topic adenocarcinoma
cirrhosis
gastrointestinal
hepatocellular carcinoma
url https://doi.org/10.1002/cnr2.70182
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