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Journal of the Korean Liver Cancer Study 2008;8(1):59-63.
Published online June 30, 2008.
A Case of Hepatocellular Carcinoma with Invasion to Bile Duct
Hyun Seok Cho, Joo Hyun Sohn, Tae Jun Byun, Sang Bong Ahn, Tae Yeob Kim, Chang Soo Eun, Yong Cheol Jeon, Dong Soo Han
Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea
Correspondence:  Joo Hyun Sohn,
Email: sonjh@hanyang.ac.kr
Copyright ©2008 by The Korean Liver Cancer Association
Abstract
A 59-year-old male patient with chronic hepatitis B and liver cirrhosis was admitted due to fever and right upper quadrant (RUQ) pain. Two years ago, he had been diagnosed with hepatocellular carcinoma with bile duct invasion and underwent left lateral segmentectomy of liver and cholecystectomy. One year after, hepatocellular carcinoma recurred in the 4th and 5th segments and transarterial chemoembolization was done for them 3 times at 2 or 3 month intervals. On this visit, he complained of general weakness, RUQ pain, fever, and weight loss. Total bilirubin was 3.1 mg/dL, ALT/AST was 81/109 IU/L, and AFP was 2.14 ng/mL. Abdomen computed tomography showed diffuse dilatation of both intrahepatic bile ducts and several small low density lesions with rim enhancement in the 4th and 8th segments. Cholangitis with liver abscesses was suspected and treatment with antibiotics started. ERCP showed narrowing of proximal and hilar portions of common bile duct and irregular shaped filling defects in the right anterior, posterior and left medial portion of intrahepatic ducts, which were believed as tumor thrombi. Despite of endoscopic retrograde biliary drainage, he died of aggravated biliary sepsis and hepatic failure.
Key Words: Bile duct invasion, Hepatocellular carcinoma; Hepatocellular carcinoma
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