{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:12:50Z","timestamp":1773007970742,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Cases<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                    <jats:p>The mean age of the patients was 77.3\u2009years (range 76\u201383), 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\u2010fetoprotein levels (mean: 737.6\u2009ng\/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\/\u03b2\u2010catenin pathway might play a key role in the pathogenesis of both HCC and gastrointestinal malignancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Synchronous HCC and gastrointestinal adenocarcinoma may be increasingly identified due to prolonged survival in cirrhotic patients. Alterations in the Wnt\/APC\/\u03b2\u2010catenin pathway could represent a shared pathogenic mechanism. Regular surveillance through ultrasound and endoscopy is essential for early diagnosis in this high\u2010risk population. Future research is needed to confirm these findings and explore targeted treatments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cnr2.70182","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T05:48:49Z","timestamp":1746769729000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association Between Hepatocellular Carcinoma and Gastrointestinal Adenocarcinoma: Is This a New Syndrome in Patients With Cirrhosis? A Case Series"],"prefix":"10.1002","volume":"8","author":[{"given":"Fabrizio","family":"Bronte","sequence":"first","affiliation":[{"name":"Gastroenterology Unit Ospedali Riuniti Villa Sofia \u2013 V. Cervello  Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"D'Amato","sequence":"additional","affiliation":[{"name":"Interventional Radiology and Neuroradiology Unit Ospedali Riuniti Villa Sofia \u2013 V. Cervello  Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Rosa","family":"Barcellona","sequence":"additional","affiliation":[{"name":"HepatOncology Unit Ospedali Riuniti Villa Sofia \u2013 V. Cervello  Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2306-2445","authenticated-orcid":false,"given":"Giuseppe","family":"Bronte","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine University of Ferrara  Ferrara Italy"},{"name":"Department of Oncology University Hospital of Ferrara  Ferrara Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Malizia","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Ospedali Riuniti Villa Sofia \u2013 V. Cervello  Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Ialuna","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit Ospedali Riuniti Villa Sofia \u2013 V. Cervello  Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Fusco","sequence":"additional","affiliation":[{"name":"HepatOncology Unit Ospedali Riuniti Villa Sofia \u2013 V. Cervello  Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Verderame","sequence":"additional","affiliation":[{"name":"Oncology Unit Ospedali Riuniti Villa Sofia \u2013 V. Cervello  Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Bronte","sequence":"additional","affiliation":[{"name":"Oncology Unit Ospedali Riuniti Villa Sofia \u2013 V. Cervello  Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Grazia","family":"Bavetta","sequence":"additional","affiliation":[{"name":"HepatOncology Unit Ospedali Riuniti Villa Sofia \u2013 V. Cervello  Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.01.002"},{"issue":"1","key":"e_1_2_11_3_1","article-title":"HCV Eradication Induced by Direct\u2010Acting Antiviral Agents Reduces the Risk of Hepatocellular Carcinoma","volume":"68","author":"Ioannou G. N.","year":"2017","journal-title":"Journal of Hepatology"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13523"},{"issue":"53","key":"e_1_2_11_5_1","first-page":"1490","article-title":"Prevalence Study of Metastases in Cirrhotic Livers","volume":"50","author":"Pereira\u2010Lima J. 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EASL Clinical Practice Guidelines on the Management of Hepatocellular Carcinoma","volume":"82","author":"European Association for the Study of the Liver","year":"2024","journal-title":"Journal of Hepatology"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2022.0404"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21420"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.06.003"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00443.x"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc3419"},{"issue":"2","key":"e_1_2_11_15_1","first-page":"713","article-title":"Multi\u2010Layered Prevention and Treatment of Chronic Inflammation, Organ Fibrosis and Cancer Associated With Canonical WNT\/\u03b2\u2010Catenin Signaling Activation (Review)","volume":"42","author":"Katoh M.","year":"2018","journal-title":"International Journal of Molecular Medicine"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.95.15.8847"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2022.0058"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2024.117508"}],"container-title":["Cancer Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.70182","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cnr2.70182","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.70182","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T20:08:58Z","timestamp":1773000538000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cnr2.70182"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1002\/cnr2.70182"],"URL":"https:\/\/doi.org\/10.1002\/cnr2.70182","archive":["Portico"],"relation":{},"ISSN":["2573-8348","2573-8348"],"issn-type":[{"value":"2573-8348","type":"print"},{"value":"2573-8348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]},"assertion":[{"value":"2024-10-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70182"}}