ABSTRACT
Radiofrequency ablation (RFA) has been widely used for treating localized hepatocellular carcinoma (HCC). Metastasis to the chest wall through the tract during performing RFA may occur uncommonly. However, it is extremely rare that massive hematochezia occurs by colonic invasion of metastatic focus on chest wall. A 48-year-old man was presented with approximately 500 cc of hematochezia. He was diagnosed as having HCC 6 years ago, and underwent RFA 3 times over a period of 5 years. Twelve months ago, right lobectomy was done on recurred lesion. 5 months ago, HCC recurred through invasion to the chest wall involving the right 5th rib, but there have been no recurrent tumor masses on the liver on CT until admission. Emergent colonoscopy demonstrated a 3 x 3 cm sized extrinsic mass on proximal transverse colon that had a blood clot. Pathology from colonic mass revealed pseudoglandular type of HCC.