ICTERIC TYPE HEPATOCELLULAR-CARCINOMA - REVISITED 20 YEARS LATER

Icteric type hepatocellular carcinoma is rare, and a poor prognosis ha s been demonstrated in the past. We performed this study to re-evaluat e prognosis since the availability of modern diagnostic modalities. Of 3921 patients with hepatocellular carcinoma in our hospital, 9 patien ts who presented with tumor fragments in common bile duct and had a pa tent portal vein were submitted for analysis. Cholangiocarcinoma was s uspected in 7 patients before the study was completed. and icteric typ e hepatocellular carcinoma was diagnosed in all 9 patients after seria l studies that included serum alpha-fetoprotein levels, computed tomog raphy, angiography, and histology. The prognosis was better in the 4 r esectable patients (survival time 16, 31, 33, and 63 months, respectiv ely), and was extremely poor for the 5 patients who received palliativ e treatment only (mean survival time, 4.5 months). Because of the appa rently discrepant outcomes, this specific type of hepatocellular carci noma should be kept in mind in areas where hepatocellular carcinomas a re prevalent, and the suspected cases should be thoroughly investigate d, because prognosis may be improved when resection is done at an earl ier stage.