Journal of Liver Cancer

Case Reports

A Case of the Effective Treatment of HCC with Bile Duct Invasion and Portal Vein Thrombosis: Jihyun An, Danbi Lee, Ju Hyun Shim, Kang Mo Kim, Young-Suk Lim, Han Chu Lee, Young-Hwa Chung, Yung Sang Lee; Journal of the Korean Liver Cancer Study Group. 2013;13(2):169-172. Published online September 30, 2013; DOI: https://doi.org/10.17998/jlc.13.2.169

Abstract PDF: Bile duct invasion of hepatocellular caricinoma (HCC) is rare, ranging from 1.2% to 9%. Moreover, the standard treatment of HCC with bile duct invasion is not yet established. We report a case of HCC with bile duct invasion and portal vein thrombosis which was successfully treated by trasarterial chemoembolization and radiotherapy. A 38-year-old female patient visited our hospital due to right upper quadrant pain. The level of total and direct bilirubin was 6.8 and 4.0 mg/dL, respectively. Her blood test showed HBs Ag positive and the level of alpha-fetoprotein was 43,000 ng/mL. Her CT scan revealed lobulating hypervascular mass involving right hepatic lobe, portal vein and both intrahepatic ducts. We performed endoscopic biliary drainage using biliary stent. She had been diagnosed as HCC on endobiliary biopsy. She was treated with radiotherapy (RT) to portal vein thrombosis, and seven transarterial chemoembolizations. After of all, we carried out radiotherapy to hepatic vein thrombosis and residual HCC near hepatic vein. After the RT, she has been taken care at outpatient clinic without evidence of recurrence during 8 months.

A Case of Hepatocellular Carcinoma With Bile Duct Thrombi Presenting Obstructive Jaundice: Su Rin Shin, Geum-Youn Gwak, Cheol Keun Park, Won Jae Lee, Moon Seok Choi, Joon Hyeok Lee, Kwang Cheol Koh, Seung Won Paik, Byung Chul Yoo; Journal of the Korean Liver Cancer Study Group. 2008;8(1):47-50. Published online June 30, 2008

Abstract PDF: Although invasion into blood vessels, particularly the portal vein, is a common feature of hepatocellular carcinoma (HCC), intrabile duct invasion has been considered rare. HCC with bile duct thrombi is occasionally misdiagnosed as biliary carcinoma or stone, and tends to have a worse clinical course than HCC without bile duct thrombi, probably attributable to the low resectability rate secondary to poor functional reserve caused by obstructive jaundice, and combined major vascular invasion. However, a few data demonstrated that obstructive jaundice aroused an early detection of HCC, leading to a better survival. Herein, we describe a case of HCC with bile duct thrombi, which was diagnosed at an early stage with obstructive jaundice and had a favorable course after surgical resection.

Extrahepatic Bile Duct Hepatocellular Carcinoma Presenting as Obstructive Jaundice: Ju Hyun Shim, Joong-Won Park, Sung-Sik Han, Joon-Il Choi, Seong Hoon Kim, Sang Jae Park, Eun Kyung Hong, Chang-Min Kim; Journal of the Korean Liver Cancer Study Group. 2008;8(1):51-54. Published online June 30, 2008

Abstract PDF: Obstructive jaundice is a rare initial symptom of hepatocellular carcinoma (HCC) patients. We herein report a patient with extrahepatic bile duct HCC mimicking common bile duct (CBD) cancer. A 55-year-old woman with no risk factors developed jaundice of the obstructive type. On dynamic computed tomography, a low attenuated mass located in the lumen of CBD with the invasion of right posterior hepatic parenchyma was identified. After percutaneous transhepatic biliary drainage, we performed hepatectomy. Pathologic examination of the lesion confirmed the diagnosis of hepatocellular carcinoma with biliary cell differentiation extended in the CBD.

Search