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Extrahepatic bile duct hepatocellular carcinoma without primary hepatic parenchymal lesions--a case report.

Cho HG, Chung JP, Lee KS, Chon CY, Kang JK, Park IS, Kim KW, Chi HS, Kim H - Korean J. Intern. Med. (1996)

Bottom Line: Extrahepatic HCCs without primary hepatic parenchymal lesions are extremely rare.The patient has been followed up for 1 year without definite evidence of recurrence.We herein report an unusual manifestation of HCC.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
Obstructive jaundice is rarely a presenting symptom of hepatocellular carcinoma (HCC). Most of the cases in the literature describing obstructive jaundice by HCC have a major hepatic component. Extrahepatic HCCs without primary hepatic parenchymal lesions are extremely rare. We encountered a case of extrahepatic HCC without primary hepatic parenchymal lesions in a 36-year-old man who presented with jaundice. We extensively sought primary hepatic parenchymal lesions preparatively and postoperatively with hepatic angiography and combined computed tomography (CT) studies, such as CT arterioportography and lipiodol-CT. The patient has been followed up for 1 year without definite evidence of recurrence. We herein report an unusual manifestation of HCC.

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Related in: MedlinePlus

Endoscopic retrograde cholangiography (A) revealed a 3×2 cm sized, oval shaped, smooth surfaced filling defect (arrows) at the upper common hepatic duct including the porta hepatis. Note bulging of the upper common hepatic duct and the bulged and dilatation of the intrahepatic ducts. On percutaneous transhepatic cholangiography (B), the mass appeared somewhat lobulated and had shallow grooves on the surface.
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f2-kjim-11-2-169-13: Endoscopic retrograde cholangiography (A) revealed a 3×2 cm sized, oval shaped, smooth surfaced filling defect (arrows) at the upper common hepatic duct including the porta hepatis. Note bulging of the upper common hepatic duct and the bulged and dilatation of the intrahepatic ducts. On percutaneous transhepatic cholangiography (B), the mass appeared somewhat lobulated and had shallow grooves on the surface.

Mentions: An ultrasound examination disclosed a mass at the hepatic hilus, dilatation of the intrahepatic bile duct and cirrhotic change of the liver. A dynamic abdominal CT scan showed an enhancing mass at the hepatic hilus, liver cirrhosis and splenomegaly without focal lesion in hepatic parenchyma (Fig. 1). An endoscopic retrograde cholangiography (ERC) revealed a 3×2 cm sized oval shaped filling defect at the upper common hepatic duct, including the porta hepatis. The surface of the mass was smooth and the upstream intrahepatic bile ducts were slightly dilated (Fig. 2A). An endoscopic nasobiliary drainage was attempted, but failed because a hydrophilic guidewire could not be passed over the obstructing mass. On a percutaneous transhepatic cholangiography (PTC) (Fig. 2B), through a percutaneous transhepatic biliary drainage (PTBD) tube, dye was well passed over the obstructing mass. The mass seemed slightly lobulated and the surface was shallowly grooved. A sono-guided fine needle aspiration cytology revealed no malignant cells. On the 24th hospital day, hepatic angiography was performed and did not show any tumor staining.


Extrahepatic bile duct hepatocellular carcinoma without primary hepatic parenchymal lesions--a case report.

Cho HG, Chung JP, Lee KS, Chon CY, Kang JK, Park IS, Kim KW, Chi HS, Kim H - Korean J. Intern. Med. (1996)

Endoscopic retrograde cholangiography (A) revealed a 3×2 cm sized, oval shaped, smooth surfaced filling defect (arrows) at the upper common hepatic duct including the porta hepatis. Note bulging of the upper common hepatic duct and the bulged and dilatation of the intrahepatic ducts. On percutaneous transhepatic cholangiography (B), the mass appeared somewhat lobulated and had shallow grooves on the surface.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4532018&req=5

f2-kjim-11-2-169-13: Endoscopic retrograde cholangiography (A) revealed a 3×2 cm sized, oval shaped, smooth surfaced filling defect (arrows) at the upper common hepatic duct including the porta hepatis. Note bulging of the upper common hepatic duct and the bulged and dilatation of the intrahepatic ducts. On percutaneous transhepatic cholangiography (B), the mass appeared somewhat lobulated and had shallow grooves on the surface.
Mentions: An ultrasound examination disclosed a mass at the hepatic hilus, dilatation of the intrahepatic bile duct and cirrhotic change of the liver. A dynamic abdominal CT scan showed an enhancing mass at the hepatic hilus, liver cirrhosis and splenomegaly without focal lesion in hepatic parenchyma (Fig. 1). An endoscopic retrograde cholangiography (ERC) revealed a 3×2 cm sized oval shaped filling defect at the upper common hepatic duct, including the porta hepatis. The surface of the mass was smooth and the upstream intrahepatic bile ducts were slightly dilated (Fig. 2A). An endoscopic nasobiliary drainage was attempted, but failed because a hydrophilic guidewire could not be passed over the obstructing mass. On a percutaneous transhepatic cholangiography (PTC) (Fig. 2B), through a percutaneous transhepatic biliary drainage (PTBD) tube, dye was well passed over the obstructing mass. The mass seemed slightly lobulated and the surface was shallowly grooved. A sono-guided fine needle aspiration cytology revealed no malignant cells. On the 24th hospital day, hepatic angiography was performed and did not show any tumor staining.

Bottom Line: Extrahepatic HCCs without primary hepatic parenchymal lesions are extremely rare.The patient has been followed up for 1 year without definite evidence of recurrence.We herein report an unusual manifestation of HCC.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
Obstructive jaundice is rarely a presenting symptom of hepatocellular carcinoma (HCC). Most of the cases in the literature describing obstructive jaundice by HCC have a major hepatic component. Extrahepatic HCCs without primary hepatic parenchymal lesions are extremely rare. We encountered a case of extrahepatic HCC without primary hepatic parenchymal lesions in a 36-year-old man who presented with jaundice. We extensively sought primary hepatic parenchymal lesions preparatively and postoperatively with hepatic angiography and combined computed tomography (CT) studies, such as CT arterioportography and lipiodol-CT. The patient has been followed up for 1 year without definite evidence of recurrence. We herein report an unusual manifestation of HCC.

Show MeSH
Related in: MedlinePlus