Initial imaging showed bile duct dilation and a mucin-producing lesion - Hematologic abnormalities (anemia, thrombocytopenia, hypofibrinogenemia) progressed over 1 month - Thrombosis in IVC, pulmonary artery, and atrium developed (similar to Trousseau syndrome) - Anticoagulation improved hematologic parameters - Right hepatic trisectionectomy and thrombectomy performed successfully - Patient recovered well and remained disease-free at 12 months follow-up. Here, MUC5AC is linked to anemia.