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Histopathological evaluation, supported by immunohistochemical staining demonstrating glypican-3 expression and p53 overexpression, confirmed the diagnosis of hepatocellular carcinoma. Given the advanced stage of disease, systemic immunotherapy with tremelimumab and durvalumab was initiated. This case underscores the critical role of a multimodal diagnostic approach in atypical presentations of HCC to enable accurate diagnosis and appropriate therapeutic decision-making.<\/jats:p>","DOI":"10.1055\/a-2864-4200","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T23:08:08Z","timestamp":1778540888000},"source":"Crossref","is-referenced-by-count":0,"title":["An unusual presentation of Hepatocellular Carcinoma: Isolated bile duct involvement without detectable hepatic mass"],"prefix":"10.1055","author":[{"given":"Nico","family":"He\u00df","sequence":"additional","affiliation":[{"name":"University Medical Center G\u00f6ttingen, NDS, Germany","place":["G\u00f6ttingen"],"department":["Gastroenterology, Gastrointestinal Oncology and Endocrinology"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"Sasse","sequence":"additional","affiliation":[{"name":"University Medical Center G\u00f6ttingen, NDS, Germany","place":["G\u00f6ttingen"],"department":["Gastroenterology, Gastrointestinal Oncology and Endocrinology"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas Roland","family":"Heiduk","sequence":"additional","affiliation":[{"name":"University Medical Center G\u00f6ttingen, NDS, Germany","place":["G\u00f6ttingen"],"department":["Gastroenterology, Gastrointestinal Oncology and Endocrinology"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albrecht","family":"Neesse","sequence":"additional","affiliation":[{"name":"University Medical Center G\u00f6ttingen, NDS, Germany","place":["G\u00f6ttingen"],"department":["Gastroenterology, Gastrointestinal Oncology and Endocrinology"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Volker","family":"Ellenrieder","sequence":"additional","affiliation":[{"name":"University Medical Center G\u00f6ttingen, NDS, Germany","place":["G\u00f6ttingen"],"department":["Gastroenterology, Gastrointestinal 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