Prognosis of hepatocellular carcinoma with bile duct tumor thrombus after R0 resection: a matched study

Wang, Dingding; Wu, Liqun; Wang, Zusen

doi:10.1016/s1499-3872(16)60143-1

Cited by 25 publications

(23 citation statements)

References 15 publications

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“…The presence of bile duct tumor thrombus associated to ICC is a very rare finding, being more common in case of hepatocellular carcinoma (2-9%) (27,28). Indeed, we found only 7 such former case reports after reviewing the literature (29,30,31).…”

Section: Discussion Discussionmentioning

confidence: 77%

Intrahepatic Cholangiocarcinoma Involving the Hepatocaval Confluence with Bile Duct Tumor Thrombus Mimicking a Klatskin Tumor: A Case Report

Botea¹,

Barcu²,

Picu³

et al. 2018

SGO

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Background: Intrahepatic cholangiocarcinoma (ICC) is a rare malignant tumor arising from the epithelial cells of the intrahepatic bile ducts. The aim of the present paper is to report a rare case of centrally located ICC involving the hepatocaval confluence and generating a tumor thrombus in the biliary duct of segment 4 expanding into the left hepatic duct and main common duct, mimicking a type IIIB Klatskin tumor. Case presentation: A 66-year old female presented for epigastric abdominal pain and weight loss, with cytolysis (ALAT= 323 U/l; normal ASAT), high GGT (618 U/L), but normal phosphatase alkaline and bilirubin levels; CA 19-9 was elevated (257 U/mL), while CEA was normal. At dual-phase multi-detector CT and magnetic resonance cholangiopancreatography, a simultaneous ICC and type IIIB perihilar cholangiocarcinoma (Klatskin tumor) were diagnosed. Intraoperatively, the ICC located in segments 1, 4 and 8, infiltrating the left and middle hepatic veins and in contact with the right hepatic vein was confirmed, while the hilar lesion proved to be a bile duct tumor thrombus originating from the ICC. Consequently, a left hepatectomy extended to segments 1 and 8 with hilar approach, with en-bloc resection of main biliary duct, and hilar lymph node dissection was performed. The right hepatic vein and an accessory middle hepatic vein were preserved, accepting 0-mm resection margin at this level. The postoperative outcome was remarkably uneventful. Conclusion: Locally advanced ICC is a challenging presentation for both diagnosis and treatment, for which complex major liver resection is effective when performed in a high volume HPB center.

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Section: Discussion Discussionmentioning

confidence: 77%

Intrahepatic Cholangiocarcinoma Involving the Hepatocaval Confluence with Bile Duct Tumor Thrombus Mimicking a Klatskin Tumor: A Case Report

Botea¹,

Barcu²,

Picu³

et al. 2018

SGO

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“…Some studies found that the large lesions, capsule in ltration, poor differentiation, portal vein invasion and intrahepatic metastasis were more frequently observed in HCC patients with BDTT [5,18,19]. These differences suggested patients with BDTT had more particular in ltrative nature, which accounted for poorer prognosis than those without BDTT even after curative resection [7][8][9][18][19][20][21]. Since the bile duct and portal vein are encapsulated in the same Glissonian sheath, tumors can easily involve both of them.…”

Section: Discussionmentioning

confidence: 99%

Imaging features of hepatocellular carcinoma with bile duct tumor thrombus：a multicenter study

Huang¹,

Wu²,

Bai³

et al. 2020

Preprint

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Background: There are still difficult and challenging problems in diagnosis of hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) before operation. This study aimed to analyze the imaging features of HCC with B1-B3 BDTT. Methods: The clinicopathological data and imaging findings of 30 HCC patients with B1-B3 BDTT from three high-volume institutions were retrospectively reviewed. Eighteen patients underwent computed tomography (CT) scans and twelve patients underwent magnetic resonance imaging (MRI) scans before operation, respectively. The diagnosis of HCC with BDTT was conﬁrmed by postoperative pathologic examination.Results: According to Japanese classification, 5 patients were classified as B1 BDTT, 12 B2, 13 B3, and 82 B4, respectively. The HCC lesions were detected in all patients, and the localized bile duct dilation were detected in 28 (93.3%) patients. The BDTT was observed in all B3 patients and 3 B2 patients, but it was not observed in all B1 patients on CT or MRI. The BDTT showed relatively hypoattenuation on plain CT scans and T1W images, relatively hyperattenuation signals on T2W. The BDTT showed hyperattenuation at hepatic arterial phase with washout at portal venous phase. The localized biliary dilation showed no enhancement at hepatic arterial phase and no progressively delayed enhancement at portal venous phase, but it was more obvious at portal venous phase on CT.Conclusions: The HCC lesions and the localized bile duct dilatation on CT or MRI scans are imaging features of HCC with BDTT, which might facilitate the early diagnosis for B1-B3 BDTT.

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“…PVTT and BDTT occur more frequently in HCC than ICC. Reports show that the incidence of HCC with PVTT ranges from 14 to 44% [4] , [9] , [10] , and HCC with BDTT ranges from 2 to 9% [1] , [2] , [3] , [11] . Conversely, ICC with BDTT or PVTT is rare.…”

Section: Discussionmentioning

confidence: 99%

Mass-forming intrahepatic cholangiocarcinoma with portal vein tumor thrombus and bile duct tumor thrombus: A case report

Iwaki

Kaido

Yamamoto

et al. 2017

International Journal of Surgery Case Reports

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Prognosis of hepatocellular carcinoma with bile duct tumor thrombus after R0 resection: a matched study

Cited by 25 publications

References 15 publications

Intrahepatic Cholangiocarcinoma Involving the Hepatocaval Confluence with Bile Duct Tumor Thrombus Mimicking a Klatskin Tumor: A Case Report

Intrahepatic Cholangiocarcinoma Involving the Hepatocaval Confluence with Bile Duct Tumor Thrombus Mimicking a Klatskin Tumor: A Case Report

Imaging features of hepatocellular carcinoma with bile duct tumor thrombus：a multicenter study

Mass-forming intrahepatic cholangiocarcinoma with portal vein tumor thrombus and bile duct tumor thrombus: A case report

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