MINUTE HEPATOCELLULAR-CARCINOMA RUPTURED INTO THE BILIARY TREE AND REVEALED BY HEMOBILIA

In hepatocellular carcinoma, invasion of the biliary, tree usually occ urs in large tumors. We report a case of a minute hepatocellular carci noma which invaded the biliary tree and was revealed by secondary hemo bilia, in a 65-old alcoholic patient with cirrhosis. The tumour was no t identified by preoperative morphological examinations. Surgical expl oration was performed due to unexplained hemobilia. Tumoral debris wer e observed in the right intrahepatic biliary tract during operative ch oledoscopy, justifying a right hepatectomy A 5 mm diameter tumour was found in liver specimen. No recurrence had occurred after 22 months. I n conclusion, in cirrhotic patients, unexplained hemobilia can reveal a small, potentially curable, hepatocellular carcinoma which has sprea d to the biliary tree.