Department of Surgery, Akita University School of Medicine, l-l-l Hondo, Akita, 010-8543 Japan.
HPB (Oxford). 2004;6(1):21-4. doi: 10.1080/13651820310017129.
Despite improved diagnostic tools, it is often difficult to make a correct diagnosis of small hepatocellular carcinoma (HCC) in patients with obstructive jaundice.
Three cases of small HCC (<2 cm diameter) presenting as obstructive jaundice are reported. All tumours were initially diagnosed as hilar cholangiocarcinoma based on ultrasonography, computed tomography, cholangiography and angiography. Because of insufficient hepatic function, none of the patients underwent hepatic resection. One patient died 8 months after first admission to our hospital, another died of disseminated intravascular coagulation I month after admission, and the third was treated with hepatic arterial infusion chemotherapy and survived >36 months.
It is important to consider HCC in the diagnosis of obstructive jaundice in patients who are predisposed to HCC because of liver cirrhosis and/or chronic viral hepatitis, and have elevated serum alpha-fetoprotein.
尽管诊断工具有所改进，但对于伴有梗阻性黄疸的小肝细胞癌（HCC）患者，常常难以做出正确诊断。
报告了 3 例直径<2cm 的小 HCC （HCC）表现为梗阻性黄疸。所有肿瘤最初均根据超声、CT、胆管造影和血管造影诊断为肝门部胆管癌。由于肝功能不足，均未进行肝切除术。1 例患者在首次入院后 8 个月死亡，另 1 例患者在入院后 1 个月死于弥散性血管内凝血，第 3 例患者接受肝动脉灌注化疗，且存活时间>36 个月。
对于因肝硬化和/或慢性病毒性肝炎而有 HCC 发病倾向、血清甲胎蛋白升高的梗阻性黄疸患者，应考虑 HCC 的诊断。
