A Resected Case of Icteric Type Hepatoma with Tumor Thrombi in Common Bile Duct

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71-year-old male was admitted to the department of gastroenterology of our hospital to treat for jaundice at July 10, 2002. His serum total bilirubin was 18.3 mg/dl and Alpha-fetoprotein was 50.2 ng/ml. Then, percutaneous tanshepatic biliary drainage (PTBD) was performed through the left lateral and the right anterior segmental bile. Computed tomography with enhancement showed the tumors in the medial segment and caudate lobe with tumor thrombi extending to the common bile duct. Left hemihepatectomy and extrahepatic bile duct resection were performed. As a gross finding of the removed specimen, the tumor thrombi extended through the left bile duct into the common bile duct from medial segmental tumor without necrosis and hemorrhage. Histological examination showed the tumor to be moderately differentiated hepatocellular carcinoma. The hepatic arterial, portal and hepatic venous branches were not involved by the tumor.

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