BACKGROUND: This study describes the clinicopathologic features of minute intrahepatic cholangiocarcinoma (ICC) and clarifies the relation between minute nodular ICC and hepatitis viral infection. METHODS: The presence of hepatitis C virus antibody (anti-HCV) and hepatitis B surface antigen (HBsAg) was examined in the serum of 50 patients with ICC who underwent hepatectomy from 1990-1996. The ICCs included 12 minute tumors (<3 cm in greatest dimension), 6 of which were nodular type and 6 others were nonnodular type (5 of periductal spreading or infiltrating type and 1 of intraductal type). RESULTS: Of these 50 patients with ICC, 16 (32%) were positive for anti-HCV, 5 (10%) were positive for HBsAg, and 1 (2%) was positive for both. The prevalence of hepatitis viral infection in cases of minute nodular-type tumor (83%; 5 patients positive for anti-HCV) was significantly higher than that in cases of minute nonnodular-type tumor (0%; P < 0.05). These minute nodular-type tumors were detected during follow-up of patients with chronic hepatitis or cirrhosis. All patients were treated with hepatectomy alone. At last follow-up, 3 patients had been free of disease for >5 years after surgery. However, 1 patient died 2 years after surgery because of remnant liver and lymph node recurrence. CONCLUSIONS: Minute nodular ICC appears to be related to hepatitis viral infection and could be detected at an early stage, similar to hepatocellular carcinoma, by following up cases of chronic hepatitis or cirrhosis.
BACKGROUND: This study describes the clinicopathologic features of minute intrahepatic cholangiocarcinoma (ICC) and clarifies the relation between minute nodular ICC and hepatitis viral infection. METHODS: The presence of hepatitis C virus antibody (anti-HCV) and hepatitis B surface antigen (HBsAg) was examined in the serum of 50 patients with ICC who underwent hepatectomy from 1990-1996. The ICCs included 12 minute tumors (<3 cm in greatest dimension), 6 of which were nodular type and 6 others were nonnodular type (5 of periductal spreading or infiltrating type and 1 of intraductal type). RESULTS: Of these 50 patients with ICC, 16 (32%) were positive for anti-HCV, 5 (10%) were positive for HBsAg, and 1 (2%) was positive for both. The prevalence of hepatitis viral infection in cases of minute nodular-type tumor (83%; 5 patients positive for anti-HCV) was significantly higher than that in cases of minute nonnodular-type tumor (0%; P < 0.05). These minute nodular-type tumors were detected during follow-up of patients with chronic hepatitis or cirrhosis. All patients were treated with hepatectomy alone. At last follow-up, 3 patients had been free of disease for >5 years after surgery. However, 1 patient died 2 years after surgery because of remnant liver and lymph node recurrence. CONCLUSIONS: Minute nodular ICC appears to be related to hepatitis viral infection and could be detected at an early stage, similar to hepatocellular carcinoma, by following up cases of chronic hepatitis or cirrhosis.