Obstructive Jaundice by Tumor Emboli from Intrahepatic Cholangiocarcinoma

Choi, Ho Soon; Park, Joon Yong; Eun, Chang Soo; Cho, Yun Ju; Sohn, Young Woo; Han, Dong Soo; Sohn, Joo Hyun; Jun, Yong Chul; Yoon, Byeong Chul; Ham, Joon Soo; Lee, Min Ho; Lee, Dong Hoo; Kee, Chun Suhk; Park, Kyung Nam; Lee, Kwang Soo; Lim, Hyun Chul; Koh, Byung Hee

Abstract

Tumor emboli of intrahepatic cholangiocarcinoma in bile duct rarely cause obstructive jaundice. Intraductal tumor embolus is associated with advanced stage of tumor within the liver, and shows poor prognosis and brief survival. However, jaundice by tumor embolus from intrahepatic cholangiocarcinoma must be distinguished from jaundice by common cause, which can be palliated safely and effectively. A patient presented with 1-month history of jaundice and epigastric pain. On cholangiography, polypoid filling defect was observed in the common hepatic duct, which had dilated proximal intrahepatic bile duct and mass shadow on the left lobe of liver. Tumor resection, embolectomy, and bile duct decompression were performed and the obstructive jaundice was relieved. Tumor embolus from intrahepatic cholangiocarcinoma was confirmed intraoperatively and pathologically as the cause of bile duct obstruction. In this report, we describe the rare case of obstructive jaundice by tumor emboli from intrahepatic cholangiocarcinoma with a review of literatures.