SpyGlass in Diagnosis of Hepatocellular Carcinoma with Right Hepatic Duct Tumor Thrombus Hemorrhage: A Case Report

Li-Hua Guo; Min Miao; Guo-Liang Ye

doi:10.24920/004273

Your Location：

Home >

Browse articles >

SpyGlass in Diagnosis of Hepatocellular Carcinoma with Right Hepatic Duct Tumor Thrombus Hemorrhage: A Case Report

Chinese Medical Sciences Journal Vol. 38, Issue 4, Pages: 309-314(2023)

Case Report | Updated：2024-05-21

- SpyGlass in Diagnosis of Hepatocellular Carcinoma with Right Hepatic Duct Tumor Thrombus Hemorrhage: A Case Report
- Affiliations：
  
  Department of Gastroenterology, the First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang 315020, China
- Author bio：
  
  *ndfyygl@163.com
- Funds：
- DOI：10.24920/004273
  CLC：
- Received：15 June 2023，
  
  Accepted：2023-10-17，
  
  Published Online：11 December 2023，
  
  Published：30 December 2023
- Accepted：
Scan QR Code
Li-Hua Guo, Min Miao, Guo-Liang Ye. SpyGlass in Diagnosis of Hepatocellular Carcinoma with Right Hepatic Duct Tumor Thrombus Hemorrhage: A Case Report[J]. Chinese medical sciences journal, 2023, 38(4): 309-314.
DOI：

Li-Hua Guo, Min Miao, Guo-Liang Ye. SpyGlass in Diagnosis of Hepatocellular Carcinoma with Right Hepatic Duct Tumor Thrombus Hemorrhage: A Case Report[J]. Chinese medical sciences journal, 2023, 38(4): 309-314. DOI： 10.24920/004273.

摘要

肝细胞癌伴胆管肿瘤血栓是一种相对罕见的疾病，预后较差。该病的主要临床表现是梗阻性黄疸，常被误诊。本例患者59岁，女性，因突发腹痛入院。实验室检查提示梗阻性黄疸，上腹部增强磁共振成像未见明显胆道扩张。超声内镜和内镜逆行胰胆管造影提示上胆管占位性病变，但性质不明。SpyGlass和活检最终证实肝细胞癌伴右肝管肿瘤血栓出血。SpyGlass直视系统作为一种先进的胆道镜设备，具有单人操作以及直视病灶且容易获取病理组织等优点。

Abstract

Hepatocelluar carcinoma presenting as a biliary duct tumor thrombus is a relatively rare entity

with poor prognosis. The primary clinical manifestation of this disease is obstructive jaundice

which can often be misdiagnosed. A 59-year-old female patient was admitted with sudden onset of abdominal pain. Laboratory tests suggested obstructive jaundice

and enhanced magnetic resonance imaging of the upper abdomen did not show obvious biliary dilatation. Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography suggested an occupying lesion in the upper bile duct. SpyGlass and biopsy finally confirmed hepatocellular carcinoma with right hepatic duct tumor thrombus hemorrhage. The SpyGlass Direct Visualization System

as an advanced biliary cholangioscopy device

showed the advantages of single-person operation as well as easy access to and visualization of the lesion.

关键词

Keywords

references

Kim DS , Kim BW , Hatano E , et al . Surgical outcomes of hepatocellular carcinoma with bile duct tumor thrombus: a Korea-Japan multicenter study . Ann Surg 2020 ; 271 ( 5 ): 913 - 21 .doi: 10.1097/SLA.0000000000003014 https://dx.doi.org/10.1097/SLA.0000000000003014 . https://journals.lww.com/10.1097/SLA.0000000000003014 https://journals.lww.com/10.1097/SLA.0000000000003014

Suh YG , Kim DY , Han KH , et al . Effective biliary drainage and proper treatment improve outcomes of hepatocellular carcinoma with obstructive jaundice . Gut Liver 2014 ; 8 ( 5 ): 526 - 35 . doi: 10.5009/gnl13370 https://dx.doi.org/10.5009/gnl13370 .

Zhou X , Wang J , Tang M , et al . Hepatocellular carcinoma with hilar bile duct tumor thrombus versus hilar cholangiocarcinoma on enhanced computed tomography: a diagnostic challenge . BMC Cancer 2020 ; 20 ( 1 ): 54 . doi: 10.1186/s12885-020-6539-7 https://dx.doi.org/10.1186/s12885-020-6539-7 .

Koo CS , Ho KY , Pang YH , et al . Extraction of intra-biliary hepatocellular carcinoma by endoscopic retrograde cholangiopancreatography . BMC Gastroenterol 2020 ; 20 ( 1 ): 408 . doi: 10.1186/s12876-020-01552-0 https://dx.doi.org/10.1186/s12876-020-01552-0 .

Orimo T , Kamiyama T , Yokoo H , et al . Hepatectomy for hepatocellular carcinoma with bile duct tumor thrombus, including cases with obstructive jaundice . Ann Surg Oncol 2016 ; 23 ( 8 ): 2627 - 34 . doi: 10.1245/s10434-016-5174-7 https://dx.doi.org/10.1245/s10434-016-5174-7 .

Sun J , Wu J , Shi J , et al . Thrombus-first surgery for hepatocellular carcinoma with bile duct tumor thrombus . J Gastrointest Surg 2021 ; 25 ( 8 ): 1973 - 9 . doi: 10.1007/s11605-020-04813-1 https://dx.doi.org/10.1007/s11605-020-04813-1 .

Dave MS , Mobarak S , Tarazi M , et al . Bile duct tumour thrombosis: hepatocellular carcinoma presenting with obstructive jaundice . Br J Hosp Med (Lond) 2021 ; 82 ( 8 ): 1 . doi: 10.12968/hmed.2021.0030 https://dx.doi.org/10.12968/hmed.2021.0030 .

Ueda M , Takeuchi T , Takayasu T , et al . Classification and surgical treatment of hepatocellular carcinoma (HCC) with bile duct thrombi . Hepatogastroenterol 1994 ; 41 ( 4 ): 349 - 54 .

Liu QY , Huang SQ , Chen JY , et al . Small hepatocellular carcinoma with bile duct tumor thrombi: CT and MRI findings . Abdom Imaging 2010 ; 35 ( 5 ): 537 - 42 . doi: 10.1007/s00261-009-9571-2 https://dx.doi.org/10.1007/s00261-009-9571-2 . http://link.springer.com/10.1007/s00261-009-9571-2 http://link.springer.com/10.1007/s00261-009-9571-2

Wu J , Huang L , Bai Y , et al . Imaging features of hepatocellular carcinoma with bile duct tumor thrombus: a multicenter study . Front Oncol 2021 ; 11 : 723455 . doi: 10.3389/fonc.2021.723455 https://dx.doi.org/10.3389/fonc.2021.723455 . https://www.frontiersin.org/articles/10.3389/fonc.2021.723455/full https://www.frontiersin.org/articles/10.3389/fonc.2021.723455/full

Zhou D , Hu GF , Gao WC , et al . Hepatocellular carcinoma with tumor thrombus in bile duct: a proposal of new classification according to resectability of primary lesion . World J Gastroenterol 2020 ; 26 ( 44 ): 7005 - 21 . doi: 10.3748/wjg.v26.i44.7005 https://dx.doi.org/10.3748/wjg.v26.i44.7005 . https://www.wjgnet.com/1007-9327/full/v26/i44/7005.htm https://www.wjgnet.com/1007-9327/full/v26/i44/7005.htm

Matsumi A , Kato H , Ueki T , et al . Effectiveness, safety, and factors associated with the clinical success of endoscopic biliary drainage for patients with hepatocellular carcinoma: a retrospective multicenter study . BMC Gastroenterol 2021 ; 21 ( 1 ): 28 . doi: 10.1186/s12876-020-01594-4 https://dx.doi.org/10.1186/s12876-020-01594-4 .

Karagyozov P , Boeva I , Tishkov I . Role of digital single-operator cholangioscopy in the diagnosis and treatment of biliary disorders . World J Gastrointest Endosc 2019 ; 11 ( 1 ): 31 - 40 . doi: 10.4253/wjge.v11.i1.31 https://dx.doi.org/10.4253/wjge.v11.i1.31 .

Pereira P , Mascarenhas M , Ribeiro T , et al . Automatic detection of tumor vessels in indeterminate biliary strictures in digital single-operator cholangioscopy . Endosc Int Open 2022 ; 10 ( 3 ): E262 - 8 . doi: 10.1055/a-1723-3369 https://dx.doi.org/10.1055/a-1723-3369 .

Wen LJ , Chen JH , Xu HJ , et al . Efficacy and safety of digital single-operator cholangioscopy in the diagnosis of indeterminate biliary strictures by targeted biopsies: a Systematic Review and Meta-Analysis . Diagnostics (Basel) 2020 ; 10 ( 9 ): 666 . doi: 10.3390/diagnostics10090666 https://dx.doi.org/10.3390/diagnostics10090666 .

Views

312

Downloads

CSCD

Alert me when the article has been cited

Submit

Publicity Resources

No data

Related Author

Li-Hua Guo

Min Miao

Guo-Liang Ye

Related Institution

Department of Gastroenterology, the First Affiliated Hospital of Ningbo University

⁰