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Abstract

In this case report we describe the case of a patient with cirrhosis who presented with jaundice and initial labs and imaging suggestive of biliary obstruction. The diagnosis of HCC was then made during ERCP with blood clot extraction followed by pathologic analysis of the thrombus. Making the diagnosis promptly and safely permitted the patient to be discharged days later and pursue palliative care measures while avoiding risky and expensive tests. Such an unusual presentation and style of diagnosis has been described only once in the literature to our knowledge, in an image-based report that did not include a discussion or literature review.