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Obstructive jaundice caused by hepatocellular carcinoma: Detection by endoscopic sonography

Tumor thrombus in the extrahepatic biliary tree is a rare mechanism of obstructive jaundice. We present a patient with a minute hepatocellular carcinoma in the caudate lobe that invaded the common hepatic duct and caused biliary obstruction. Endoscopic sonography showed a tumor thrombus with central echogenicity and a “nodule‐in‐nodule” pattern and suggested the correct diagnosis. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:363–366, 2001.