Korean J Med.  2008 Nov;75(5):559-563.

A case of extrahepatic bile duct hepatocellular carcinoma with no detectable primary hepatic tumor

Affiliations
  • 1Department of Internal Medicine, Kyung-Hee University School of Medicine, Seoul, Korea. krjoo@khu.ac.kr
  • 2Department of Pathology, Kyung-Hee University School of Medicine, Seoul, Korea.

Abstract

Obstructive jaundice associated with hepatocellular carcinoma (HCC) is an uncommon symptom caused by intraductal tumor growth, the migration of tumor necrosis, blood clots within the biliary tract, or compression of the biliary tract by the tumor. Most cases of icteric-type HCC involve a main tumor in the liver parenchyma. Bile duct HCC without a primary hepatic tumor is extremely rare, but because it shows similar clinical manifestations and imaging results to extrahepatic bile duct cancer, it is possible to misdiagnose this condition as a primary bile duct tumor or choldocholithiasis. Recently, we experienced a case of obstructive jaundice associated with an extrahepatic bile duct tumor in a 69-year-old woman. Upon radiologic studies and endoscopic cholangiography, the cause of obstructive jaundice was initially attributed to the bile duct tumor itself. However, subsequent analysis indicated that the condition was, in fact, due to bile duct thrombi associated with extrahepatic bile duct HCC.

Keyword

Extrahepatic bile duct; Hepatocellular carcinoma; Obstructive jaundice; Thrombus

MeSH Terms

Aged
Bile Ducts
Bile Ducts, Extrahepatic
Biliary Tract
Carcinoma, Hepatocellular
Cholangiography
Female
Humans
Jaundice
Jaundice, Obstructive
Liver
Necrosis
Thrombosis
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