An icteric type hepatocellular carcinoma with no detectable tumor in the liver but with an intrabile duct recurrent tumor]

A 70-year-old man was admitted to our hospital with obstructive jaundice. We performed a laparotomy. The intraductal tumor was removed with the extrahepatic bile ducts. A histological examination of the tumor showed an icteric type hepatocellular carcinoma. The recurrent tumor was detected as intrajejunal tumor thrombi by a CT scan. No lesions were detected in the liver by a CT scan, ultrasonography, and angiography. We performed the second laparotomy. The tumor thrombi in jejunal limb were removed. At 2 months after the operation, an intrahepatic lesion and tumor thrombi were detected. TACE were performed two times and the response was CR. At 16 months after the operation, no recurrence has been seen in this patient.