A Case of Concomitant Hemorrhagic Hepatocellular and Gallbladder Carcinomas

Abstract

We report a case of concomitant hemorrhagic hepatocellular and gallbladder carcinomas. A 71–year–old man admitted for right hypochondrial pain was found in abdominal computed tomography (CT) to have a hemorrhagic hepatic tumor and cholelithiasis. He was taking warfarin for atrial fibrillation, and PT–INR was extended to 3.27 in blood tests, indicating progressive anemia and inflammation. Abdominal ultrasonography and CT showed gallbladder hemorrhaging and cholecystitis. Partial hepatectomy (S5/6) and cholecystectomy were done following endoscopic nasogallbladder drainage to improve the man′s general condition. Pathological diagnosis of the resected specimen showed concomitant hepatocellular and gallbladder carcinomas, with both becoming hemorrhagic. No such case has, to our knowledge, been reported in the Japanese literature. In our case, anticoagulant therapy and cholecystitis due to gallstones led to gallbladder carcinoma hemorrhaging.