A solitary recurrence of bile duct tumor thrombus after hepatectomy for hepatocellular carcinoma: A case report

Abstract

A 73-year-old man with hepatocellular carcinoma (HCC) (S4 4.0 cm, S8 1.2 cm) underwent partial hepatectomy (S4) and intraoperative radio frequency ablation (S8) (well to moderately differentiated HCC, vp1, vv0, va0, b1, sm-). A year later, he was readmitted due to obstructive jaundice. An abdominal enhanced computed tomography and endoscopic retrograde cholangiography revealed a tumor thrombus in left bile duct without any evidence of other tumor mass in the liver parenchyma. We diagnosed that HCC had a recurrence as a bile duct tumor thrombus solitarily and left hemihepatectomy was performed. Micro residual tumor at liver cutting surface of first hepatectomy or implantation of a fragment from micro tumor thrombus may be presumed cause of recurrence. We have to pay attention to a solitary recurrence of bile duct tumor thrombus even in case of HCC with invasion to peripheral biliary duct. A systematic extended hepatectomy should be firstly selected in such case.