A special recurrent pattern in small hepatocellular carcinoma after treatment: Bile duct tumor thrombus formation

Figure 2 Small hepatocellular carcinoma in a 57-year-old male. A: Computed tomography (CT) shows primary sHCC (arrow) in segment V at the hepatic arterial phase; B: Forty-seven months after the initial operation, CT reveals a BDTT (arrows) with characteristics of early enhancement at the hepatic arterial phase; C: Tumor thrombus (arrows) extending through the common hepatic duct into the common bile duct is demonstrated during PTCD; D: Cancer nest invasion into the bile duct wall is observed histologically (HE, × 100). sHCC: Small hepatocellular carcinoma; BDTT: Bile duct tumor thrombus; HE: Hematoxylin and eosin; PTCD: Percutaneous transhepatic cholangial drainage.