Hepatocellular Carcinoma Presenting Extrahepatic Biliary Obstruction

Abstract

An autopsy case of hepatocellular carcinoma presenting extrahepatic obstructive jaundice was reported. The patient was a 68‐year‐old man with 5‐year history of chronic liver disease and markedly jaundiced, and died of gastrointestinal hemorrhage. Autopsy revealed hepatocellular carcinoma associated with liver cirrhosis and metastatic polypoid growth in the common bile duct and cystic duct which completely obstructed the duct lumen. Obstructive jaundice secondary to complete obstruction of the common bile duct was a rare complication of hepatocellular carcinoma. The other 85 cases of hepatocellular carcinoma presenting extrahepatic biliary obstruction are reviewed.

Mechanical and Anatomical Causes of Bile Duct

“…First, the term is mostly used for those HCCs that cause obstructive jaundice by floating tumor debris in the common bile duct, as outlined below (Chen 2002). Other situations include direct invasion of ducts by HCC (Afroudakis et al 1978), sometimes with polypoid intraluminal growth (Nonomura et al 1983), hemorrhagic obturating clot formation (Creed and Fisher 1956), and hemobilia (Johns and Zimmerman 1961). A distinct situation is characterized by usually stenosing HCC apparently arising outside the liver substance proper.…”