A Case of Cholangiocellular Carcinoma with Atrophy of the Right Lobe of the Liver and Tumor Embolus in the Right Main Branch of the Portal Vein

Masaya Shito, Junichi Shintoku, Hiroshi Miyazaki, Shusaku Kamei

Department of Surgery, General Ota Hospital

A rare case of asymptomatic cholangiocellular carcinoma with hepatitis B virus infection with atrophy of the right lobe of the liver and tumor embolus in the right main branch of the portal vein is described. A 59-year-old man visited our hospital with an elevation of biliary enzymes that was detected during an annual medical examination. Abdominal ultrasonography (US) showed an isoechoic mass measuring 76×51 mm in the right lobe of the liver. The diagnosis was confirmed with computed tomography (CT), endoscopic retrograde cholangiography (ERC) and angiography. No primary malignant focus was found in other organs. A curative operation, which included right trisegmentectomy with caudate lobectomy and common bile duct resection with regional lymph node dissection, was performed. The intrahepatic bile duct of the lateral segment was reconstructed to the jejunum by a Roux-en-Y procedure. Microscopic examination of the tumor revealed moderately differentiated tubular adenocarcinoma compatible with cholangiocellular carcinoma. These results suggest that screening with US may reveal liver dysfunction even in asymptomatic cases. For better prognosis, aggressive surgery may be an effective treatment even in advanced cases.

Key words
cholangiocellular carcinoma, tumor embolus of the portal vein, hepatitis B virus infection

Reprint requests
Masaya Shito Department of Surgery, General Ota Hospital
29-5 Hachiman-cho, Ota, 373 JAPAN

Accepted
June 12, 1996

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