A Case of Small-sized Hepatocellular Carcinoma Inducing Obstructive Jaundice with Dilatation of Left Intrahepatic Bile Duct

Seisuke Sakamoto, Iwao Ikai, Koujirou Taura, Fusao Ikeda, Taisuke Morimoto, Yoshio Yamaoka

Gastroenterological Surgery, Kyoto University Gradute School of Medicine

A 63-year-old man was admitted to a hospital with right hypochondralgia and jaundice. Preoperative imaging studies showed dilatation of the left intrahepatic duct and a filling defect in the common bile duct. Accordingly, a diagnosis of choledocholithiasis was made and he underwent laparatomy. At laparatomy, only clotted blood was found in the common bile duct. During operative cholangioscopy, an elevated lesion was observed on the left hepatic duct. The lesion showed malignant neoplasia histologically. The patient was referred to our hospital. Re-examination was performed after admission, but no space occupying lesion was revealed in the liver. Under a preoperative diagnosis of cancer of the left hepatic duct, he underwent left hepatic lobectomy with bile duct reconstruction. Macroscopically, a small tumor (1.0×0.5 cm) was found in the liver along the left hepatic bile duct near the hepatic hilum. Histopathologically, it was diagnosed as a moderately differentiated hepatocellular carcinoma with tumor thrombus in the branches of the left intrahepatic bile duct. This is a rare case of a small hepatocellular carcinoma inducing obstructive jaundice with dilatation of the left intrahepatic bile duct.

Key words
obstructive jaundice, small sized hepatocellular carcinoma, bile duct thrombus

Reprint requests
Iwao Ikai Gastroenterological Surgery, Kyoto University Graduate School of Medicine
54 Kawaracho, Shogoin, Sakyoku, Kyoto, 606-01 JAPAN

Accepted
October 9, 1996

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