Bile duct hepatocellular carcinoma thrombi

Area of Science:

• Hepatology
• Gastroenterology
• Oncology

Background:

• Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death, often diagnosed at advanced stages despite surveillance.
• While surveillance improves early diagnosis, some patients still present with advanced disease.
• Uncommon presentations of HCC, such as bile duct tumor thrombi, pose diagnostic challenges.

Observation:

• A 34-year-old male presented with progressive jaundice due to bile duct tumor thrombi.
• The biliary lesion mimicked common bile duct stones (choledocholithiasis) and cholangiocarcinoma.
• Distinguishing these biliary lesions from HCC thrombi is clinically difficult.

Findings:

• Endoscopic retrograde cholangiopancreatography (ERCP) was performed for diagnosis and intervention.
• Thrombi were extracted from the common bile duct during ERCP.
• Histopathological examination of the thrombi confirmed the diagnosis of Hepatocellular carcinoma (HCC).

Implications:

• This case underscores the importance of considering HCC in the differential diagnosis of biliary obstruction, even in younger patients.
• Rare presentations of HCC necessitate a high index of suspicion and advanced diagnostic techniques.
• Timely diagnosis and intervention, as demonstrated by ERCP, are crucial for managing HCC complications.