Abstract
A 58-year-old man admitted for jaundice was found in computed tomography (CT) to have a circumfer-entially enhanced tumor in the medial segment of the liver (S4) and a homogeneously enhanced tumor in the dilated left hepatic duct to the common hepatic duct. Cholangiography using an endoscopic nasal biliary drainage (ENBD) tube showed a smooth, soft filling defect in the common hepatic duct, yielding a diagnosis of cholangiocellular carcinoma, necessitating left hepatectomy with extra-hepatic bile duct resection and removal of the bile duct tumor. Postoperative histopathological examination showed the tumor to be moderately differen- tiated hepatocellular carcinoma invading the biliary tract. PIVKA-II has been pointed out in the literature as a valuable marker of this disease. To improved the disease prognosis, early differential diagnosis of obstructive jaundice with bearing this disease in mind and radical hepatectomy with extra-hepatic bile duct resection are considered to important.
