A Resected Case of Hepatocellar Carcinoma with Hemobilia from Intrabile Duct Tumor Thrombus

Yutaka Takahashi, Masakazu Yamamoto, Takehito Ohtsubo, Hideo Katsuragawa, Satoshi Katagiri, Kenji Yoshitoshi, Ken Takasaki and Ichigenn Tokinaga*

The Institute of Gastroenterology, Tokyo Women's Medical College
Department of Internal Medicine, Yamato Seiwa Hospital*

A 75-year-old man with hepatocellular carcinoma repeatedly undergoing TAE and PEIT war referred for tumor recurrence. He underwent TAE once more, but the tumor did not decrease in size, and he was readmitted. On the day of admission, he reported tarry stool followed by upper abdominal pain and nausea upon evacuation. His hemoglobin decreased to 8.3 g/dl. Ultrasonography and CT showed an intrabile duct tumor thrombus at the lateral segment of the liver and dilatation of the peripheral bile duct. Angiography showed a slight tumor stain at the lateral segment of the liver. Percutaneous transhepatic cholangiography did not show the left bile duct, but showed filling defects in the common bile duct. Based on a diagnosis of hepatocellular carcinoma with hemobilia from an intrabile duct tumor thrombus. We conducted left hepatic lobectomy and incision of the common bile duct with removal of coagula. Pathology revealed poorly differentiated hepatocellular carcinoma with sarcomatous changes.

Key words
hepatocellular carcinoma, intrabile duct tumor thrombus, hemobilia

Reprint requests
Yutaka Takahashi The Institute of Gastroenterology, Tokyo Women's Medical College
8-1 Kawada-cho, Shinnjyuku-ku, 162-8666 JAPAN

Accepted
March 24, 2004

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