Journal of Liver Cancer

Case Reports

Rare Clinical and Radiologic Case of Cholangiocarcinoma Mimicking Pyogenic Abscess, Hepatic Echinococcal Cysts, and Metastases: Si Hyeong Lee, Soo Hyung Ryu, Dong Hoon Lee, Won Eui Yoon, Tae Young Park, Hye Kyung Lee, Jeong Seop Moon; J Liver Cancer. 2020;20(2):173-176. Published online September 30, 2020; DOI: https://doi.org/10.17998/jlc.20.2.173

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Cholangiocarcinoma is a biliary carcinoma with a wide spectrum of imaging, histological, and clinical features. In immunocompromised patients, pyogenic abscesses are relatively common and an echinococcal hepatic cysts are very rare. The authors experienced a very rare case of cholangiocarcinoma showing multiple hypodense masses with wall enhancement mimicking pyogenic liver abscess, echinococcal hepatic cyst, and cystic metastases. An 83-year-old man, complaining of fatigue and poor oral intake, presented to our outpatient clinic. Abdominal computed tomography (CT) revealed multiple, variable-sized hypodense masses with peripheral rim enhancement throughout the liver. Dynamic liver magnetic resonance images also showed findings similar to those of a CT scan. We performed ultrasound-guided biopsy of the mass which revealed cholangiocarcinoma.

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Surgical strategy for incidental intrahepatic cholangiocarcinoma in terms of lymph node dissection
Sung Hyun Kim, Dai Hoon Han, Gi Hong Choi, Jin Sub Choi, Kyung Sik Kim
Journal of Gastrointestinal Surgery.2024; 28(6): 910. CrossRef

Two Cases of Spontaneous Bacterial Peritonitis Developed Right after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: Jung Hoon Lee, Joo Hyun Sohn, Tae Yeob Kim, Ji Young Lee, Ki Sul Chang, Dong Hoon Lee, Eun Sik Park; Journal of the Korean Liver Cancer Study Group. 2013;13(2):145-151. Published online September 30, 2013; DOI: https://doi.org/10.17998/jlc.13.2.145

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Abstract PDF: Although acute hepatic failure (AHF) after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) is not a rare complication, the development of spontaneous bacterial peritonitis (SBP) is uncommon. We describe two cases who suffered SBP and AHF right after TACE for HCCs. In the first case, 5 days after TACE ascites and jaundice newly developed and SBP was diagnosed at 9 days after TACE. After use of secondary antibiotics (imipenam) due to failure of primary therapy with 3rd cephalosporin, he discharged with resolution of SBP. In the second case, jaundice, abdominal pain and fever developed with increased ascites 3 days after TACE. After 8 days, SBP was diagnosed and treated with imipenam due to primary treatment failure, but clinical course was deteriorated. Eighteen days after discharge, she died of AHF. In patients with increased ascites and fever after TACE, clinician should be considered SBP with AHF among post-TACE complications, and prompt management is needed.

A Case of the Complete Remission of a Solitary Extrahepatic Bile Duct Hepatocellular Carcinoma without Primary Hepatic Parenchymal Lesions by Cyberknife Treatment: Soung Won Jeong, Si Hyun Bae, Hyun Young Woo, Chan Ran You, Won Hang Hur, Jong Young Choi, Seung Kew Yoon, Dong Hoon Lee, Young Jun Lee, Jae Young Byun, Hong Seok Jang; Journal of the Korean Liver Cancer Study Group. 2008;8(1):92-97. Published online June 30, 2008

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Abstract PDF: A 69-year-old man patient was hospitalized by confused mentality. He had chronic hepatitis B virus infection and was diagnosed with liver cirrhosis 20 years ago. Abdominal CT showed about 2×1 cm sized polypoid mass with mild arterial enhancement at the S4 of liver, causing moderate dilatation of the left IHBD. In the CTHA-AP, intraductal mass was hyperattenuated at arterial phase and washed out at portal phase. Celiac angiography revealed nodular tumor staining correlating to intraductal mass on CT. In MRCP and ERCP, a polypoid lesion was noted at the orifice of left main intrahepatic duct. The patient was treated with cyber-knife for 3 days with 3600 cGy. In follow up CT after 2 month of cyber-knife treatment, there was regression of previously noted left IHBD dilatation and no definite enhancing intraductal mass.

A Case of Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis Achieving Complete Response with New Therapeutic Modalities: Hyun Young Woo, Jin Dong Kim, Jung Hyun Kwon, Chan Ran You, Jeong Won Jang, Si Hyun Bae, Jong Young Choi, Se Hyun Cho, Seung Kew Yoon, Dong Hoon Lee, Ho Jong Chun, Byung Gil Choi, Chul Seung Kay; Journal of the Korean Liver Cancer Study Group. 2008;8(1):124-127. Published online June 30, 2008

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Abstract PDF: A 45-year-old man was admitted for the treatment of hepatocellular carcinoma (HCC). He was diagnosed hepatitis B carrier 16 years ago and has not done a routine check. Abdominal CT showed a diffuse infiltrative HCC involving right hepatic lobe with portal vein tumor thrombosis (PVTT) involving right portal vein and proximal portion of left portal vein umbilical portion. With concurrent transcatheter arterial chemotherapy (TAC), helical tomotherapy for portal vein thrombosis was done. With these treatments, main tumor and PVTT was decreased in size markedly and no stain in hepatic angiogram. Due to repeated TAC, hepatic arterial stenosis occurred and TAC was stopped. 3 months after, recurrent tumor was detected in MRI. Radiofrequency ablation followed by High Intensity Focused Ultrasound (HIFU) was done for this recurrent mass. No viable mass was shown in the follow up MRI done 6 months after HIFU.

Combined hepatocellular and cholangiocarcinoma: Jung Hyun Kwon, Si Hyun Bae, Jung Pil Suh, Ho Sung Park, Chan Ran You, Jong Young Choi, Seung Kew Yoon, Dong Hoon Lee, Ho Jong Chun, Byung Gil Choi, Chan Kwon Chung, Eun Sun Jung, Mi Ryung Ryu; Journal of the Korean Liver Cancer Study Group. 2007;7(1):49-54. Published online June 30, 2007

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Abstract PDF: A 43 year-old-women patient was admitted for one month of jaundice. She was diagnosed hepatitis B carrier 17 years ago and has not done a routine check. Abdominal CT showed a large ill defined mass in left hepatic lobe with inhomogenous enhancement in arterial and delayed phase. The result of biopsy including the immunohistochemical stains showed the combined hepatocellular and cholangiocarcinoma (stage IVa, type C by Allen and Lisa). With the radiation therapy (3,910 cGy), six times of transarterial chemo-lipiodolization and two times of percutaneous ethanol injection, huge mass was markedly decreased in size and no stain in hepatic angiogram. She underwent left lobectomy.

A Case of Cyberknife Treatment for Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: Chan Ran You, Si Hyun Bae, Hyun Young Woo, Soung Won Jeong, Jong Young Choi, Seung Kew Yoon, Hong Seok Jang, Dong Hoon Lee, Byung Gil Choi; Journal of the Korean Liver Cancer Study Group. 2007;7(1):82-86. Published online June 30, 2007

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Abstract PDF: A 64 year-old-male patient was transferred to our hospital for infiltrative hepatocellular carcinoma (HCC) without treatment response because of treatment failure and disease progression. He had been diagnosed infiltrating HCC 9 months ago and then treated with three times of transarterial chemolipiodolization (TACL) in other hospital. But, HCC was progressed. Abdominal CT showed infiltrating HCC in S7 and a small daughter nodule in S8 with right and main portal vein tumor thrombosis (PVTT). We performed stereotatic radiosurgery (Cyberknife) for the treatment of PVTT and four times of TACL for the treatment of intrahepatic HCC every 4weeks. The total radiation doses using with Cyberknife were 36Gy with a prescription isodose 80% in 3 fractions over the three consecutive days. After treatment, infiltrating HCC was decreased in size and PVTT was markedly regressed. Response rate of serum AFP was 57.2%. In conclusion, we report the case of good treatment response in the patient with HCC with PVTT after combination treatment of Cyberknife and TACL.

A Case of Advanced Hepatocellular Carcinoma Treated with Hepatic Arterial Infusion Chemotherapy: So Yeon Lee, Si Hyun Bae, Min Su Kim, Jong Young Choi, Seung Kew Yoon, Dong Hoon Lee, Ho Jong Choen; Journal of the Korean Liver Cancer Study Group. 2006;6(1):52-55. Published online June 30, 2006

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Abstract PDF: A 57 year-old-male patient was admitted to our hospital for evaluation of hepatic mass which was detected on ultrasonography. He had history of chronic hepatitis B and alcoholism. Laboratory findings showed that HBsAg was positive, and HBeAg was negative. AFP was 5.39 ng/mL. Abdominal CT showed large ill-defined low density lesion in 4, 7 and 8 segment of the liver with tumor thrombosis at umbilical portion of left portal vein, which was compatible with advanced hepatocellular carcinoma (stage IVb). Celiac and hepatic arteriogram revealed huge hypervascular mass at both lobe of the liver. Chemoport catheter was inserted to the right hepatic artery and intra-arterial chemotherapy (epirubicin 50 mg every 4 weeks, cisplatin 25 mg and 5-FU 200 mg weekly) was started with continuous infusion device. After 3 cycles of repeated intra-arterial chemotherapy, tumor mass in both hepatic lobe were decreased in size and extent. He is planned to be treated with additional intra-arterial chemotherapy.

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