Hepatocellular carcinoma treated with radical resection after endoscopic diagnosis of the extent of bile duct invasion: A case report

Abstract Hepatocellular carcinoma invasion of the bile duct is rare and has a poor prognosis. A 77‐year‐old man presented at the emergency department with persistent pain in the right hypochondrium. Blood tests and imaging studies revealed a 70‐mm occupying lesion in the right lobe of the liver and...

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Main Authors: Yudai Sato, Tomoko Tadokoro, Hiroki Yamana, Hiraki Akai, Kei Takuma, Naoki Fujita, Mai Nakahara, Kyoko Oura, Koji Fujita, Joji Tani, Hideki Kamada, Asahiro Morishita, Hideki Kobara, Seiko Kagawa, Reiji Haba, Keiichi Okano, Tsutomu Masaki
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:DEN Open
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Online Access:https://doi.org/10.1002/deo2.265
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author Yudai Sato
Tomoko Tadokoro
Hiroki Yamana
Hiraki Akai
Kei Takuma
Naoki Fujita
Mai Nakahara
Kyoko Oura
Koji Fujita
Joji Tani
Hideki Kamada
Asahiro Morishita
Hideki Kobara
Seiko Kagawa
Reiji Haba
Keiichi Okano
Tsutomu Masaki
author_facet Yudai Sato
Tomoko Tadokoro
Hiroki Yamana
Hiraki Akai
Kei Takuma
Naoki Fujita
Mai Nakahara
Kyoko Oura
Koji Fujita
Joji Tani
Hideki Kamada
Asahiro Morishita
Hideki Kobara
Seiko Kagawa
Reiji Haba
Keiichi Okano
Tsutomu Masaki
author_sort Yudai Sato
collection DOAJ
description Abstract Hepatocellular carcinoma invasion of the bile duct is rare and has a poor prognosis. A 77‐year‐old man presented at the emergency department with persistent pain in the right hypochondrium. Blood tests and imaging studies revealed a 70‐mm occupying lesion in the right lobe of the liver and dilated intrahepatic bile ducts. He was diagnosed with obstructive jaundice and cholangitis. Imaging studies showed an internal mass with poor contrast effects. A liver biopsy was performed to confirm the diagnosis and hepatocellular carcinoma was suspected. Endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, and peroral cholangioscopy were performed to determine the treatment strategy. The bile duct invasion did not extend to the porta hepatis; therefore, right hepatic lobectomy and radical resection were performed. Bile duct invasion in hepatocellular carcinoma is rare and often difficult to diagnose by computed tomography or conventional endoscopic retrograde cholangiopancreatography. However, endoscopic ultrasound and peroral cholangioscopy enable safe and accurate diagnosis of the extent of invasion.
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spelling doaj-art-fc380b8c52934850ae901bdfcd0465992025-08-20T03:38:54ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.265Hepatocellular carcinoma treated with radical resection after endoscopic diagnosis of the extent of bile duct invasion: A case reportYudai Sato0Tomoko Tadokoro1Hiroki Yamana2Hiraki Akai3Kei Takuma4Naoki Fujita5Mai Nakahara6Kyoko Oura7Koji Fujita8Joji Tani9Hideki Kamada10Asahiro Morishita11Hideki Kobara12Seiko Kagawa13Reiji Haba14Keiichi Okano15Tsutomu Masaki16Department of Gastroenterology and Neurology Kagawa University KagawaJapanDepartment of Gastroenterology and Neurology Kagawa University KagawaJapanDepartment of Gastroenterology and Neurology Kagawa University KagawaJapanDepartment of Gastroenterology and Neurology Kagawa University KagawaJapanDepartment of Gastroenterology and Neurology Kagawa University KagawaJapanDepartment of Gastroenterology and Neurology Kagawa University KagawaJapanDepartment of Gastroenterology and Neurology Kagawa University KagawaJapanDepartment of Gastroenterology and Neurology Kagawa University KagawaJapanDepartment of Gastroenterology and Neurology Kagawa University KagawaJapanDepartment of Gastroenterology and Neurology Kagawa University KagawaJapanDepartment of Gastroenterology and Neurology Kagawa University KagawaJapanDepartment of Gastroenterology and Neurology Kagawa University KagawaJapanDepartment of Gastroenterology and Neurology Kagawa University KagawaJapanDepartment of Pathology Kagawa University KagawaJapanDepartment of Pathology Kagawa University KagawaJapanDepartment of Gastroenterological Surgery Kagawa University KagawaJapanDepartment of Gastroenterology and Neurology Kagawa University KagawaJapanAbstract Hepatocellular carcinoma invasion of the bile duct is rare and has a poor prognosis. A 77‐year‐old man presented at the emergency department with persistent pain in the right hypochondrium. Blood tests and imaging studies revealed a 70‐mm occupying lesion in the right lobe of the liver and dilated intrahepatic bile ducts. He was diagnosed with obstructive jaundice and cholangitis. Imaging studies showed an internal mass with poor contrast effects. A liver biopsy was performed to confirm the diagnosis and hepatocellular carcinoma was suspected. Endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, and peroral cholangioscopy were performed to determine the treatment strategy. The bile duct invasion did not extend to the porta hepatis; therefore, right hepatic lobectomy and radical resection were performed. Bile duct invasion in hepatocellular carcinoma is rare and often difficult to diagnose by computed tomography or conventional endoscopic retrograde cholangiopancreatography. However, endoscopic ultrasound and peroral cholangioscopy enable safe and accurate diagnosis of the extent of invasion.https://doi.org/10.1002/deo2.265bile duct invasionEUShepatocellular carcinomaperoral cholangioscopysurgery
spellingShingle Yudai Sato
Tomoko Tadokoro
Hiroki Yamana
Hiraki Akai
Kei Takuma
Naoki Fujita
Mai Nakahara
Kyoko Oura
Koji Fujita
Joji Tani
Hideki Kamada
Asahiro Morishita
Hideki Kobara
Seiko Kagawa
Reiji Haba
Keiichi Okano
Tsutomu Masaki
Hepatocellular carcinoma treated with radical resection after endoscopic diagnosis of the extent of bile duct invasion: A case report
DEN Open
bile duct invasion
EUS
hepatocellular carcinoma
peroral cholangioscopy
surgery
title Hepatocellular carcinoma treated with radical resection after endoscopic diagnosis of the extent of bile duct invasion: A case report
title_full Hepatocellular carcinoma treated with radical resection after endoscopic diagnosis of the extent of bile duct invasion: A case report
title_fullStr Hepatocellular carcinoma treated with radical resection after endoscopic diagnosis of the extent of bile duct invasion: A case report
title_full_unstemmed Hepatocellular carcinoma treated with radical resection after endoscopic diagnosis of the extent of bile duct invasion: A case report
title_short Hepatocellular carcinoma treated with radical resection after endoscopic diagnosis of the extent of bile duct invasion: A case report
title_sort hepatocellular carcinoma treated with radical resection after endoscopic diagnosis of the extent of bile duct invasion a case report
topic bile duct invasion
EUS
hepatocellular carcinoma
peroral cholangioscopy
surgery
url https://doi.org/10.1002/deo2.265
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