Abstract

A 40-year old patient with chronic hepatitis B was admitted to our hospital due to right quardrant abdominal pain and jaundice for 2 days. One month ago, he had been treated for acute cholangitis. Total bilirubin was 6.69 mg/dL, AST/ALT level 150/165 IU/L, and AFP 6.7ng/mL. Abdomen CT showed that diffusely irregular tortuous dilatation of IHBD was noted in S 6, more markedly in the peripheral portion, with rather higher density than fluid within lumen, suggesting mucin producing biliary tumor. ERCP demonstrated that a long segment movable filling defect was present at CHD, proximal CBD and posterior right intrahepatic duct. Suggesting sludge and posterior inferior segment of right intrahepatic duct was not visualized with filling defects. At that point we suspected that his diagnosis was cholangiocarcinoma. So we carried out the surgical resection. The pathologic results were hepatocellular carcinoma with bile duct invasion. Because of the incomplete resection of hepatocellular carcinoma, TAC was performed twice during the next 2 months. After then he has been taken care at OPD with good condition. This case shows that hepatocellular carcinoma is early detected by bile duct dilatation on CT and successfully treated by surgical intervention and TAC.

• Keywords: Hepatocellular carcinoma;Bile duct invasion;Right lobectomy