An autopsy case of hepatocellular carcinoma with growth in the bile duct diagnosed by percutaneous transhepatic cholangiography

We describe the features of 24 cases of hepatocellular carcinoma (HCC) with prominent intrabile duct tumor growth seen among 238 autopsy and 21 surgical cases of HCC. Progressive obstructive jaundice occurred during the course of most cases and was the presenting sign in nine. A fluctuating rise and fall of the total bilirubin was seen in two cases. The average survival time of the cases was significantly shorter than that of HCC patients without intrabile duct tumor growth (Mann-Whitney's U-test, one-tailed, P less than 0.05). The average survival time after the development of severe jaundice (total bilirubin over 10 mg/dl) was only 16 days. Intrabile duct tumor casts were located in the hepatic and/or the common bile ducts in 19 cases (79%) and in five cases were seen in the peripheral (medium to small-sized) bile ducts. Hemobilia developed in five cases (21%) and was regarded as the immediate cause of death in one. Grossly all the cases presented infiltrative or mixed (infiltrative and nodular) growth pattern. Intrabile duct tumor growth and associated marked obstructive jaundice may frequently herald the terminal phase of HCC in certain patients. In our series, approximately 40% of patients with HCC and significant jaundice had gross evidence of extensive intraductal tumor growth. In the absence of intraductal tumor growth, jaundice in HCC usually was seen in a setting of progressive terminal hepatic failure.

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Hepatocellular carcinoma presenting as intrabile duct tumor growth. A clinicopathologic study of 24 cases

Kojiro

Kawabata

Kawano

et al. 1982

Cancer

215

118

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Resection of hepatocellular carcinoma with obstructive jaundice caused by compression of the common hepatic duct

Lee

Sakai

Kinoshita

et al. 1988

Journal of Surgical Oncology

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We treated a patient with hepatocellular carcinoma in whom jaundice was caused by obstruction of the common hepatic duct because of compression by the tumor. Percutaneous transhepatic cholangiodrainage was performed preoperatively. The tumor was entirely in the medial segment of the liver, without invasion of the hepatic ducts, and medial segmentectomy was performed. As of the end of 1985, 58 cases of hepatocellular carcinoma complicated by extrahepatic obstructive jaundice have been reported in Japan. In only four was obstructive jaundice caused by extraluminal biliary compression. We review ten patients treated by liver resection.

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Hepatocellular Carcinoma Presenting Extrahepatic Biliary Obstruction

Nonomuea

Ohta

Kanai

et al. 1983

Acta Pathologica Japonica

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An autopsy case of hepatocellular carcinoma presenting extrahepatic obstructive jaundice was reported. The patient was a 68‐year‐old man with 5‐year history of chronic liver disease and markedly jaundiced, and died of gastrointestinal hemorrhage. Autopsy revealed hepatocellular carcinoma associated with liver cirrhosis and metastatic polypoid growth in the common bile duct and cystic duct which completely obstructed the duct lumen. Obstructive jaundice secondary to complete obstruction of the common bile duct was a rare complication of hepatocellular carcinoma. The other 85 cases of hepatocellular carcinoma presenting extrahepatic biliary obstruction are reviewed.

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An autopsy case of hepatocellular carcinoma with growth in the bile duct diagnosed by percutaneous transhepatic cholangiography

Cited by 3 publications

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Hepatocellular carcinoma presenting as intrabile duct tumor growth. A clinicopathologic study of 24 cases

Hepatocellular carcinoma presenting as intrabile duct tumor growth. A clinicopathologic study of 24 cases

Resection of hepatocellular carcinoma with obstructive jaundice caused by compression of the common hepatic duct

Hepatocellular Carcinoma Presenting Extrahepatic Biliary Obstruction

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