A Case of Hepatocellular Carcinoma Presenting Obstructive Jaundice as a Result of Growing into the Bile Duct

Takanori Shimura, Masaru Suzuki, Tsuyoshi Tsukamoto, Masao Sanada, Kenji Mogi, Satoshi Nozawa, Masao Hirata, Akio Konno*

Department of Surgery and Department of Pathology*, Chiba Rosai Hospital

We experienced a case of hepatocellular carcinoma (HCC) presenting as obstructive jaundice as a result of its growth into the bile duct, and it was difficult to distinguish HCC from cholangiocellular carcinoma (CCC). The patient is a 43-year-old man complaining of back pain. Abdominal echography and CT revealed a 6 cm diameter tumor with localized bile duct dilatation in the left lobe of the liver. After admission, he gradually presented a clinical picture of obstructive jaundice, and percutaneous transhepatic cholangiography (PTC) was carried out. On the PTC, a soft radiolucent shadow from the left hepatic duct to the common bile duct was seen. A celiotomy was carried out under the suspected diagnosis of CCC, and left lobectomy with resection of the caudate lobe and the bile duct was performed. Macroscopic examination of the surgical specimen showed a tumor in the lateral segment, and from the tumor a thrombus was serially growing into the left hepatic duct and common bile duct. Histologically, all lesions were HCC of Edmondson's grade II without any component of CCC. The patient has been followed up with no evidence of recurrence.

Key words
hepatocellular carcinoma, obstructive jaundice, bile duct invasion

Reprint requests
Takanori Shimura Department of Surgery, Chiba Rosai Hospital
2-16 Tatsumidai Higashi, Ichihara, 290 JAPAN

Accepted
May 13, 1992

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