A Resected Case of Hepatocellular Carcinoma Invading the Biliary Tract with Obstructive Jaundice -Review of the Recent 19 Japanese Cases-

Yoshihide Nagasako, Kazuhito Misawa, Masaaki Watanabe, Seiji Oguro, Kimiharu Hasegawa, Shigechika Kohashi, Yumi Okawa and Hidekazu Sano

Department of Surgery, Sapporo City General Hospital

A 58-year-old man admitted for jaundice was found in computed tomography (CT) to have a circumferentially enhanced tumor in the medial segment of the liver (S4) and a homogeneously enhanced tumor in the dilated left hepatic duct to the common hepatic duct. Cholangiography using an endoscopic nasal biliary drainage (ENBD) tube showed a smooth, soft filling defect in the common hepatic duct, yielding a diagnosis of cholangiocellular carcinoma, necessitating left hepatectomy with extra-hepatic bile duct resection and removal of the bile duct tumor. Postoperative histopathological examination showed the tumor to be moderately differentiated hepatocellular carcinoma invading the biliary tract. PIVKA-II has been pointed out in the literature as a valuable marker of this disease. To improved the disease prognosis, early differential diagnosis of obstructive jaundice with bearing this disease in mind and radical hepatectomy with extra-hepatic bile duct resection are considered to important.

Key words
hepatocellular carcinoma invading the biliary tract, obstructive jaundice

Reprint requests
Yoshihide Nagasako Division of Surgery, Sapporo City General Hospital
Kita-11, Nishi-13, Chuo-ku, Sapporo, 060-8604 JAPAN

Accepted
November 26, 2003

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