A Case Report of Mass-foming Intrahepatic Cholangiocarcinoma with Intraductal Tumor Thrombus

Shigeru Hibino, Susumu Fujioka, Kenji Kato, Yuichi Machiki, Yasushi Kutsuna, Yasushi Takenouchi, Daisuke Takara, Hideki Matsuba, Hirofumi Morimae and Katsue Yoshida^*

Department of Surgery and Pathology^*, Kiryu Kousei General Hospital

A 78-year-old woman with anorexia was found in an abdominal ultrasonography to have a hypoechoic irregular mass with a right dilated intrahepatic duct in the right lobe. Abdominal CT showed a low-density mass in the right lobe. The peripheral intrahepatic duct of the mass and the right caudate branch were dilated. Another nodular mass attached to the right portal vein was located at low density on CT. Portography via the superior mesentric artery showed slight compression of the right portal vein and obstruction of the right anterior segmental vein. ERCP showed a filling defect suspected as an intraductal tumor thrombus at the hepatic hilus. Right extended hepatectomy and right caudate lobectomy combined with bile duct resection were done under a diagnosis of intrahepatic cholangiocarcinoma. Resected specimens showed a tumor thrombus from the right intrahepatic duct to the extrahepatic duct. Microscopic findings showed moderately differentiated intrahepatic cholangiocarcinoma. The gross appearance of the tumor was mass-forming and intraductal growth on macroscopic classification.

Key words
intrahepatic cholangiocarcinoma, mass-forming, intraductal tumor thrombus

Reprint requests
Shigeru Hibino Department of Surgery, Kiryu Kousei General Hospital 6-3 Orihime-cho, Kiryu, 379-0024 JAPAN

Accepted
March 26, 2003

To read the PDF file you will need Abobe Reader installed on your computer.