HEPATOCELLULAR CARCINOMA PRESENTING EXTRAHEPATIC OBSTRUCTIVE JAUNDICE DUE TO BILE DUCT INVASION-CLINICOPATHOLOGICAL STUDY OF TWO CASES

Two rare cases of autopsy and surgery presenting extrahepatic biliary obstruction due to intrabile-duct growth of hepatocellular carcinoma were reported. Clinically obstructive jaundice was predominant in comparison with the other symptoms in both cases. In one autopsy case, hepatocellular carcinoma developed in the right lobe of the cirrhotic liver (posthepatitic). It involved the secondary branch of the right hepatic duct and grew into the common hepatic duct. In the other case of surgical operation, hepatocellular carcinoma, which developed in the posterior portion of the right lobe of the cirrhotic liver (posthepatitic), destroyed the posterior wall of the bifurcation of the bilateral hepatic duct and obstructed the common hepatic duct due to the intraductal cancer growth. From the site of the bile duct invasion or permeation by the tumor, two cases were classified into the peripheral (the former case) and proximal (the latter case) types, respectively. Furthermore, as far as obstructive jaundice is clinically concerned, the possibility should be kept in mind that hepatocellular carcinoma may proliferate into the large bile ducts, apart from that of cholangiocarcinoma or cholelithiasis