{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:11:41Z","timestamp":1792098701903,"version":"4.4.0"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T00:00:00Z","timestamp":1607299200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Hepatocellular carcinoma with biliary ductal invasion is rare and associated with a significantly lower survival rate.\n<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>We present an unusual case of a patient with hepatocellular carcinoma and biliary invasion, who had his diagnosis confirmed by histological analysis from tissue extracted by endoscopic retrograde cholangiopancreatography. An 87-year-old male presented with a 1-day history of right upper quadrant pain and jaundice. His past medical history included recurrent gallstone cholangitis and a previous cholecystectomy. An abdominal CT demonstrated a dilated intrahepatic biliary tree with left proximal intrahepatic hyperdensities, as well as a 3\u2009cm hepatocellular carcinoma. He was initially suspected to have concurrent gallstone cholangitis and a newly diagnosed hepatocellular carcinoma. Endoscopic retrograde cholangiopancreatography and balloon trawling of the intraductal lesions extracted necrotic tumour-like tissue which was histologically consistent with hepatocellular carcinoma. The extraction of the intra-biliary portion of HCC resulted in complete resolution of his jaundice, enabling further treatment with nivolumab, which would not have been possible if the obstruction was not cleared. The patient is currently well and has completed his 6th cycle of nivolumab.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Obstructive jaundice is an uncommon presentation for patients with HCC. it is key for clinicians to be aware of the possibility of intrabiliary invasion in order obtain an early diagnosis and to reduce any delay in treatment.\n<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12876-020-01552-0","type":"journal-article","created":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T10:05:56Z","timestamp":1607335556000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Extraction of intra-biliary hepatocellular carcinoma by endoscopic retrograde cholangiopancreatography"],"prefix":"10.1186","volume":"20","author":[{"given":"Chieh Sian","family":"Koo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khek Yu","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin Huei","family":"Pang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5165-5061","authenticated-orcid":false,"given":"Daniel Q.","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,12,7]]},"reference":[{"issue":"10","key":"1552_CR1","doi-asserted-by":"publisher","first-page":"2144","DOI":"10.1002\/1097-0142(19820515)49:10<2144::AID-CNCR2820491026>3.0.CO;2-O","volume":"49","author":"M Kojiro","year":"1982","unstructured":"Kojiro M, Kawabata K, Kawano Y, Shirai F, Takemoto N, Nakashima T. Hepatocellular carcinoma presenting as intrabile duct tumor growth: a clinicopathologic study of 24 cases. Cancer. 1982;49(10):2144\u20137.","journal-title":"Cancer."},{"issue":"3","key":"1552_CR2","doi-asserted-by":"publisher","first-page":"385","DOI":"10.3748\/wjg.v9.i3.385","volume":"9","author":"LX Qin","year":"2003","unstructured":"Qin LX, Tang ZY. Hepatocellular carcinoma with obstructive jaundice: diagnosis, treatment and prognosis. World J Gastroenterol. 2003;9(3):385\u201391.","journal-title":"World J Gastroenterol"},{"issue":"1","key":"1552_CR3","doi-asserted-by":"publisher","first-page":"192","DOI":"10.3350\/cmh.2016.22.1.192","volume":"22","author":"AY Kim","year":"2016","unstructured":"Kim AY, Jeong WK. Intraductal malignant tumors in the liver mimicking cholangiocarcinoma: imaging features for differential diagnosis. Clin Mol Hepatol. 2016;22(1):192\u20137.","journal-title":"Clin Mol Hepatol"},{"issue":"3","key":"1552_CR4","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s002610000029","volume":"25","author":"MJ Diaz-Ruiz","year":"2000","unstructured":"Diaz-Ruiz MJ, Falc\u00f3 J, Martin J, Bella RM, Carrasco M, Tortajada L. Hepatocellular carcinoma presenting as portal thrombosis with intrabiliary growth: US and MR findings. Abdom Imaging. 2000;25(3):263\u20135.","journal-title":"Abdom Imaging"},{"issue":"2","key":"1552_CR5","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1007\/s002610000136","volume":"26","author":"JH Tseng","year":"2001","unstructured":"Tseng JH, Hung CF, Ng KK, Wan YL, Yeh TS, Chiu CT. Icteric-type hepatoma: magnetic resonance imaging and magnetic resonance cholangiographic features. Abdom Imaging. 2001;26(2):171\u20137.","journal-title":"Abdom Imaging"},{"issue":"6","key":"1552_CR6","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1016\/S0960-7404(10)80042-8","volume":"4","author":"WY Lau","year":"1995","unstructured":"Lau WY, Leung KL, Leung TW, Ho S, Chan M, Liew CK, et al. Obstructive jaundice secondary to hepatocellular carcinoma. Surg Oncol. 1995;4(6):303\u20138.","journal-title":"Surg Oncol"},{"issue":"1","key":"1552_CR7","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1007\/PL00009966","volume":"33","author":"GT Huang","year":"1998","unstructured":"Huang GT, Sheu JC, Lee HS, Lai MY, Wang TH, Chen DS. Icteric type hepatocellular carcinoma: revisited 20 years later. J Gastroenterol. 1998;33(1):53\u20136.","journal-title":"J Gastroenterol"},{"issue":"9","key":"1552_CR8","doi-asserted-by":"publisher","first-page":"e94","DOI":"10.1016\/j.cgh.2011.03.011","volume":"9","author":"TG van Dinter Jr","year":"2011","unstructured":"van Dinter TG Jr, Schmidt JF, Tarnasky PR. Obstructive jaundice caused by intraductal hepatocellular carcinoma. Clin Gastroenterol Hepatol. 2011;9(9):e94\u20135.","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"1","key":"1552_CR9","doi-asserted-by":"publisher","first-page":"e364","DOI":"10.1097\/MD.0000000000000364","volume":"94","author":"H Zeng","year":"2015","unstructured":"Zeng H, Xu LB, Wen JM, Zhang R, Zhu MS, Shi XD, et al. Hepatocellular carcinoma with bile duct tumor thrombus: a clinicopathological analysis of factors predictive of recurrence and outcome after surgery. Medicine. 2015;94(1):e364.","journal-title":"Medicine."}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-020-01552-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12876-020-01552-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-020-01552-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T10:18:57Z","timestamp":1607336337000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-020-01552-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1552"],"URL":"https:\/\/doi.org\/10.1186\/s12876-020-01552-0","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12]]},"assertion":[{"value":"3 May 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 November 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 December 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent form is available for review by the Editor of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"408"}}