title: Biliary obstruction caused by intrabiliary transplantation from hepatocellular carcinoma.
abstract: 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.
authors.affiliation: Third Department of Internal Medicine, University of Occupational and Environmental Health, Japan, School of Medicine, Kitakyushu.
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Narita
authors.forename: Takeshi
authors.initials: T
authors.lastname: Oto
authors.forename: Yukiharu
authors.initials: Y
authors.lastname: Mimura
authors.forename: Masami
authors.initials: M
authors.lastname: Ono
authors.forename: Shintaro
authors.initials: S
authors.lastname: Abe
authors.forename: Akinari
authors.initials: A
authors.lastname: Tabaru
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshikawa
authors.forename: Akihide
authors.initials: A
authors.lastname: Tanimoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Otsuki
mesh_terms: 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