Case Report
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World J Gastroenterol. Mar 21, 2012; 18(11): 1273-1278
Published online Mar 21, 2012. doi: 10.3748/wjg.v18.i11.1273
Tumors with macroscopic bile duct thrombi in non-HCC patients: Dynamic multi-phase MSCT findings
Qing-Yu Liu, Xiao-Feng Lin, Hai-Gang Li, Ming Gao, Wei-Dong Zhang
Qing-Yu Liu, Xiao-Feng Lin, Ming Gao, Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
Hai-Gang Li, Department of Pathology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
Wei-Dong Zhang, Department of Radiology, Cancer Center, Sun Yat-Sen University, Guangzhou 510060, Guangdong Province, China
Author contributions: Liu QY designed the study and wrote the manuscript; Lin XF, Gao M and Zhang WD contributed to the analysis and interpretation of data; and Li HG performed the pathological analysis.
Correspondence to: Qing-Yu Liu, PhD, Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang Xi Road, Guangzhou 510120, Guangdong Province, China. liu.qingyu@163.com
Telephone: +86-20-81332243 Fax: +86-20-81332702
Received: July 14, 2011
Revised: September 20, 2011
Accepted: January 18, 2012
Published online: March 21, 2012
Abstract

Non-hepatocellular carcinoma (non-HCC) with macroscopic bile duct tumor thrombus (BDTT) formation is rare, few radiological studies have been reported. In this case report, we retrospectively analyzed the imaging findings of three cases of non-HCC with macroscopic BDTT on dynamic enhanced multislice computed tomography (MSCT) scan. One case of primary hepatic carcinosarcoma was presented as a solitary, large well-defined tumor with significant necrotic changes. One case of liver metastasis from colon cancer was presented as a lobulated, large ill-defined tumor. One case of intraductal oncocytic papillary neoplasm involved the entire pancreas, presented as a cystic and solid mass with multilocular changes (the individual loculi were less than 5.0 mm in diameter). The bile duct was dilated due to expansible growth of the BDTT in all three patients. The BDTT was contiguous with hepatic or pancreatic tumor, and both of them showed the same enhancement patterns on dynamic contrast-enhanced computed tomography scan: early enhancement in the hepatic arterial phase and a quick wash-out of contrast agent in the portal and equilibrium phases. Macroscopic BDTT in non-HCC patient is rare, dynamic enhanced MSCT scan may be valuable in the diagnosis of non-HCC with BDTT.

Keywords: Liver neoplasms; Carcinosarcoma; Metastasis; Pancreatic neoplasms; Oncocytic papillary neoplasm; Bile ducts tumor thrombus; Computed tomography; X-ray