Small hepatocellular carcinoma presenting as intrabiliary pedunculated polyp and obstructive jaundice

• Published in: Journal of clinical gastroenterology Vol. 11; no. 5; p. 578
• Main Authors: Terada, T, Nakanuma, Y, Kawai, K
• Format: Journal Article
• Language: English
• Published: United States 01.10.1989
• Subjects: Bile Duct Neoplasms - pathology; Bile Duct Neoplasms - secondary; Bile Ducts - pathology; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - pathology; Cholestasis - etiology; Humans; Liver - pathology; Liver Neoplasms - complications; Liver Neoplasms - pathology; Male; Middle Aged
• ISSN: 0192-0790
• DOI: 10.1097/00004836-198910000-00019

A rare autopsy case of small hepatocellular carcinoma presenting as an intrabiliary pedunculated mass is reported. The patient, 60-year-old man, presented with obstructive jaundice and died 1 month later. At autopsy, an intrabiliary pedunculated tumor measuring 3.5 x 2.0 x 2.0 cm was found in the hepatic, right hepatic, and right posterior segmental bile ducts. The intraductal tumor was attached to the segmental bile ductal wall, where a tumor measuring 2.0 x 0.9 cm was found in the parenchyma. The parenchymal tumor was continuous with the intrabiliary mass. Histologically, the tumor was a hepatocellular carcinoma showing acidophilic granular cytoplasm with occasional hyaline globules and was structurally arranged in a vague trabecular pattern. Immunohistochemically, tumor cells were positive for alpha-fetoprotein and alpha 1-antitrypsin, but was negative for keratin. We present a brief review of the literature of such icteric hepatocellular carcinomas.