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Leave No "Stone" Unturned: Biliary Obstruction From Isolated Intraductal Metastatic HCC
Shivani Desai1, Katrina A McGinty2, Andrew Canakis3
1University of North Carolina School of Medicine, Chapel Hill, NC.
ACG Case Reports Journal
|July 18, 2025
Summary
Metastatic hepatocellular carcinoma (HCC) to the bile duct is rare. This case highlights the importance of considering bile duct metastases in patients with liver cancer and obstructive jaundice after treatment.
Area of Science:
- Hepatobiliary surgery
- Gastroenterology
- Medical oncology
Background:
- Hepatocellular carcinoma (HCC) is a primary liver cancer.
- Metastases to the biliary tree are uncommon.
- Hepatitis C virus (HCV) cirrhosis is a common risk factor for HCC.
Observation:
- A patient with recurrent HCC and HCV cirrhosis presented with obstructive jaundice.
- The patient had previously undergone locoregional therapy.
- Imaging revealed a mass in the distal common bile duct.
Findings:
- Intraductal biopsy confirmed metastatic HCC within the common bile duct.
- This metastasis caused biliary obstruction.
- This is the first reported case in a patient without prior partial hepatectomy.
Implications:
- Bile duct metastases should be considered in HCC patients with obstructive jaundice.
- This finding is crucial for treatment planning and prognosis.
- Further research may explore the mechanisms of such rare metastases.
