A Case of Hypervascular Cholangiocellular Carcinoma with an Arterio-portal Shunt and Dual Supply of the Hepatic and the Suprarenal Artery

Hiroki Kawasumi*, Yo Sasaki, Shingi Imaoka, Seizo Masutani, Ichiro Ohashi, Atsuhiro Ogawa, Shinichi Iwamoto, Osamu Ishikawa, Hiroshi Furukawa, Takeshi Iwanaga, Hiroshi Kudo**

*Department of Surgery, Gotsu Saiseikai Hospital
Department of Surgery, The Center for Adult Diseases, Osaka
**Department of Surgery, Tottori Red Cross Hospital

Recently we experienced a case of hypervascular cholangiocellular carcinoma with an arterio-portal shunt and dual supply of the hepatic and the suprarenal artery. A 59-year-old man, in whom a large exophytic tumor in the posterior segment of the liver was pointed out in another hospital, was admitted to our center for surgery. Abdominal CT and MR images revealed a large ill-defined tumor in the posterior segment of the liver extending to the right suprarenal region. Angiography showed a markedly hypervascular tumor with an arterio-portal shunt which was fed by both the hepatic and suprarenal arteries. Right hepatectomy and adrenectomy were carried out under the diagnosis of adrenal cancer involving the liver. Histologically, the tumor was found to be a cholangiocellular carcinoma invading the right adrenal gland. The tumor consisted mainly of tubular adenocarcinoma with mucin-secreting areas accompanied by moderate fibrosis and many tumor vessels. These histologic patterns seemed to reflect the angiographic findings.

Key words
peripheral type of intrahepatic bile duct carcinoma, hypervascular cholangiocellular carcinoma with arterio-portal shunts, right adrenal invasion

Reprint requests
Hiroki Kawasumi Department of Surgery, Gotsu Saiseikai Hospital
1550 Gotsu-cho, Gotsu, 695 JAPAN

Accepted
April 17, 1991

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