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Corresponding author at: Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, 06591 Seoul, Korea.
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
A 60-year-old male with known hepatocellular carcinoma (HCC) and hepatitis B, who
was taking entecavir and had a history of 10 times transarterial chemoembolization
(TACE) procedures, presented with severe abdominal pain to the extent that he could
not walk. His-total bilirubin level was 9.30 mg/dL. Enhanced liver phase 3 dynamic
computed tomography confirmed extrahepatic biliary obstruction by an intraluminal
common bile duct (CBD) mass (marked with a dotted line) with TACE-treated HCC (arrowhead)
in the liver (Fig. 1A). On the 23rd day of hospitalization, his liver function further deteriorated that
hepatic encephalopathy was developed, and the patient eventually received living donor
liver transplantation. Explant showed cirrhotic configuration with CBD obstructed
with reddish and bulging intraluminal mass (Fig. 1B).
Fig. 1(A) CT abdomen showing extrahepatic biliary obstruction by an intraluminal CBD mass
(dotted line) with TACE-treated HCC (arrowhead) in the liver. (B) Explant showing
cirrhotic configuration with CBD obstructed with reddish and bulging intraluminal
mass. (C, D) Microscopic fundings showing stacked oval-to-spindle-shaped cells with
eosinophilic cytoplasm (C) and desmin- and MyoD1-expressing cancer cells (D), suggesting
rhabdomyosarcoma.
