Biliary obstruction caused by intrabiliary transplantation from hepatocellular carcinoma.
A rare autopsy case of hepatocellular carcinoma (HCC) presenting as extrahepatic bile duct obstruction is reported. A 54-year-old man who had been treated at another hospital for obstructive jaundice was referred to our hospital and admitted on March 1, 1998, because of progressive jaundice. On hospital day 94, he died of bleeding esophageal varices. At autopsy, a bile duct tumor, measuring 3.0 x 3.5 cm and adhering to the wall of the left hepatic duct, occluded the common hepatic duct at the hilus. A tumor measuring 2.0 x 2.0 cm was found in the parenchyma of the left liver lobe. The parenchymal tumor was not continuous with the extrahepatic bile duct tumor. Histologically, the bile duct tumor and the parenchymal tumor of the left lobe were diagnosed as HCC. The bile duct tumor was attached to the mucosa of the bile duct with a thin stalk. No invasive growth into the submucosa was observed. The tumor may have been an intrabiliary transplantation from the HCC in the left lobe via the bile duct.
Narita
Ryoichi
R
Third Department of Internal Medicine, University of Occupational and Environmental Health, Japan, School of Medicine, Kitakyushu.
Oto
Takeshi
T
Mimura
Yukiharu
Y
Ono
Masami
M
Abe
Shintaro
S
Tabaru
Akinari
A
Yoshikawa
Ichiro
I
Tanimoto
Akihide
A
Otsuki
Makoto
M
D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000556:secondary; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000175:diagnosis / Q000556:secondary; D002760:Cholangiopancreatography, Endoscopic Retrograde; D001651:Cholestasis, Extrahepatic / Q000209:etiology* / Q000473:pathology; D004932:Esophageal and Gastric Varices / Q000209:etiology; D017809:Fatal Outcome; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating