Abstract

Bile duct invasion of hepatocellular caricinoma (HCC) is rare, ranging from 1.2% to 9%. Moreover, the standard treatment of HCC with bile duct invasion is not yet established. We report a case of HCC with bile duct invasion and portal vein thrombosis which was successfully treated by trasarterial chemoembolization and radiotherapy. A 38-year-old female patient visited our hospital due to right upper quadrant pain. The level of total and direct bilirubin was 6.8 and 4.0 mg/dL, respectively. Her blood test showed HBs Ag positive and the level of alpha-fetoprotein was 43,000 ng/mL. Her CT scan revealed lobulating hypervascular mass involving right hepatic lobe, portal vein and both intrahepatic ducts. We performed endoscopic biliary drainage using biliary stent. She had been diagnosed as HCC on endobiliary biopsy. She was treated with radiotherapy (RT) to portal vein thrombosis, and seven transarterial chemoembolizations. After of all, we carried out radiotherapy to hepatic vein thrombosis and residual HCC near hepatic vein. After the RT, she has been taken care at outpatient clinic without evidence of recurrence during 8 months.

• Keywords: Hepatocellular carcinoma;Bile duct invasion;Obstructive jaundice