Bile obstruction in hepatocellular carcinoma--visualization by endoscopic retrograde cholangiography. A case report

Extrahepatic biliary obstruction is a rare presentation in hepatocellular carcinoma (HCC), only 31 cases having been reported in the literature. We describe a patient with extrahepatic biliary obstruction in whom endoscopic retrograde cholangiography was suggestive of cholangiocarcinoma. Laparotomy and subsequent investigation, however, confirmed HCC metastasizing to the common hepatic duct. The cholangiographic appearance of HCC involving extrahepatic bile ducts is emphasized and features differentiating it from cholangiocarcinoma are highlighted. Even though extrahepatic biliary obstruction in HCC is rare, this disorder should be considered in the differential diagnosis of obstructive biliary tract disease.