A case of hepatocellular carcinoma invading the gallbladder misdiagnosed as a primary gallbladder carcinoma

Abstract

Extrahepatic metastasis of hepatocellular carcinoma (HCC) is occasionally seen in the lung, bone, adrenal gland, and lymph nodes. It is well known that HCC sometimes invades the biliary system. Since there is no peritoneum between the gallbladder and the liver fossa, a gallbladder cancer easily invades the liver; however, HCC seldom invades the gallbladder because it rarely destroys the muscle layer or the collagen fibers of the gallbladder wall. Routes of gallbladder metastasis of HCC include direct invasion, extension to the biliary system, and invasion of the adjacent hepatic vascular system. Some cases of gallbladder metastasis of HCC without direct invasion have been reported. We report here a case of HCC that directly invaded the gallbladder, and that resembled gallbladder carcinoma invading the liver.

Transarterial Embolization for Cystic Artery Pseudoaneurysm Caused by Hepatocellular Carcinoma Rupture in the Gallbladder: A Case Report

“…The gallbladder is normally located on the visceral surface of the liver and fits in the fossa between subsegments IV and V. Therefore, HCC in subsegments IV or V can potentially rupture in the gallbladder; however, this is rare. One possible reason for the rarity of HCC rupture in the gallbladder may be that HCC rarely invades the gallbladder because it barely destroys the muscular layer and collagen fibers of the gallbladder wall [ 2 ]. In the present case, the ruptured tumor was mainly fed by the cystic artery, and intratumoral extravasations from multiple branches of the cystic artery were detected.…”

A Rare Presentation of Hepatocellular Carcinoma Infiltrating the Gallbladder

“…It is a well-known fact that the HCC sometimes invades the biliary system and since there is no peritoneum between the gallbladder and liver fossa, a gallbladder malignancy can easily invade the liver. However, HCC rarely infiltrates the gallbladder because it rarely destroys the muscle layer and collagen fibers of the gallbladder wall [4]. Imaging techniques play a very important role in the detection, characterization, staging, surveillance, and prognosis of HCC.…”

“…However, HCC rarely infiltrates the gallbladder because it rarely destroys the muscle layer and collagen fibers of the gallbladder wall [4]. We report here a rare case of hepatocellular carcinoma that invaded the gallbladder and was initially misdiagnosed as primary gallbladder malignancy invading the liver.…”

Invasion Patterns and Metastatic Patterns of Hepatocellular Carcinoma

“…HCC, mainly right-sided tumors, can invade or metastasize into this organ (Murakami et al 2008;Ryu et al 2009;Kanzaki et al 2011;Terada and Maruo 2013). Invading tumors macroscopically form a nodule that originates in the liver substance close to the gallbladder fossa and which extends into the gallbladder wall, with effacement of the wall structures.…”