Occult hepatocellular carcinoma: a case report of a special icteric-type hepatoma and literature review.
Hepatocellular carcinoma (HCC) presenting with obstructive jaundice due to bile duct tumour thrombi is classified as icteric-type hepatoma. This report describes a case of unusual icteric-type HCC with common bile duct thrombus, which is herein named 'occult HCC', as no detectable primary lesion in liver was defined pre-operatively and intra-operatively. A thrombectomy followed by a T biliary drainage tube placement was carried out, and the final post-operative pathological evaluation demonstrated the tumour thrombus originated from a moderately differentiated HCC. The clinicopathological features and logical clinical interventions of this rare type of HCC were discussed with a review of the literature. The HCC patients with bile duct thrombi receiving palliative biliary drainage alone had a poor outcome. With respect to improving prognosis, a curative resection of primary HCC and tumour thrombi was suggested on the basis of performing an intensive post-operative monitoring for early detection of primary liver lesion.
Chang
H
H
Department of Hepatobiliary & Pancreatic Surgery, Shandong Provincial Hospital, Shandong University School of Medicine, Shandong, China. changh111@hotmail.com
Xu
J
J
Mu
Q
Q
Qin
C
C
Zhang
Z
Z
Wu
T
T
D001652:Bile Ducts / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000473:pathology; D004322:Drainage; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology*; D008113:Liver Neoplasms / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000150:complications* / Q000473:pathology; D013927:Thrombosis / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome