title: Early hepatocellular carcinoma presenting with biliary ductal invasion--a case report.
abstract: Early and small hepatocellular carcinoma (HCC) rarely presents with biliary ductal invasion. We present a case of early HCC presenting with biliary invasion, in the absence of a mass on computed tomographic scanning. The patient, a hepatitis B carrier, was initially diagnosed to have "liver fluke infection" after a "leaf-like structure" was found within the right hepatic duct on endoscopic retrograde cholangiopancreatography (ERCP). The specimen was retrieved with a Dormia basket. Histology revealed HCC. This report highlights an unusual case of early and small HCC presenting with biliary ductal invasion. A high index of suspicion has to be entertained in the background of hepatitis B regardless of the atypicality of presentation.
authors.affiliation: Department of Pathology, Singapore General Hospital, Singapore.
authors.forename: J W
authors.initials: JW
authors.lastname: Leong
authors.forename: J M
authors.initials: JM
authors.lastname: Ho
authors.forename: H S
authors.initials: HS
authors.lastname: Ng
authors.forename: J P
authors.initials: JP
authors.lastname: Raj
mesh_terms: D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness