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Intrahepatic cholangiocarcinoma coinciding with a liver metastasis from a rectal carcinoma: a case report

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ABSTRACT

Background: We experience many cases of liver metastasis from colorectal cancer, but synchronous occurrence of intrahepatic cholangiocarcinoma (ICC) and liver metastasis from a rectal cancer is extremely rare. We herein report a case of ICC coinciding with a liver metastasis from a known rectal carcinoma.

Case presentation: A 68-year-old man was referred to our hospital for investigation of multiple liver tumors. Total colonoscopy and computed tomography (CT) revealed a rectal carcinoma, coinciding with liver metastasis. He was planned to receive chemotherapy following rectal resection. During chemotherapy for the rectal cancer, one of the liver tumors gradually grew after first shrinking. The following hepatectomy revealed the presence of intrahepatic cholangiocarcinoma (ICC). Despite intensive chemotherapy for the ICC, he passed away 6 months after the hepatectomy.

Conclusions: We should also suspect the possibility of multiple primary cancers, even if the patient has a history of cancer that is likely to cause metastatic lesions. When simultaneous neoplasms are diagnosed, systematic treatment should be targeted to the tumor with the worst prognosis.

No MeSH data available.


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a Microscopic findings of the S2 tumor show moderately differentiated intrahepatic cholangiocarcinoma (H&E staining ×400). b Carcinoma cells are negative for CDX-2 (on immunohistochemistry, ×100). c Carcinoma cells are positive for CD19 (on immunohistochemistry, ×100). d Carcinoma cells are positive for hepatocytes (on immunohistochemistry, ×100)
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Fig2: a Microscopic findings of the S2 tumor show moderately differentiated intrahepatic cholangiocarcinoma (H&E staining ×400). b Carcinoma cells are negative for CDX-2 (on immunohistochemistry, ×100). c Carcinoma cells are positive for CD19 (on immunohistochemistry, ×100). d Carcinoma cells are positive for hepatocytes (on immunohistochemistry, ×100)

Mentions: We assumed the neoadjuvant chemotherapy was not effective for the S2 lesion, so we decided to perform an extended left hepatectomy. The images of the tumor are shown in Fig. 1, and the clinical course is summarized in Table 1. To our surprise, pathological examination showed intrahepatic cholangiocarcinoma (ICC), moderately differentiated, 55 mm × 50 mm × 40 mm, s1, ne1, vp1, vv1, va0, b1. The carcinoma cells were positive for CD10 and CD19 and negative for hepatocyte, glypican 3, CK7, and CDX2 (Fig. 2). In the segments of hepatic tissue, no metastatic adenocarcinoma was found. According to the TNM classification, the pathological stage of the ICC was IVa (T4N0M0). The postoperative course was uneventful, and he was discharged on the 12th postoperative day.Table 1


Intrahepatic cholangiocarcinoma coinciding with a liver metastasis from a rectal carcinoma: a case report
a Microscopic findings of the S2 tumor show moderately differentiated intrahepatic cholangiocarcinoma (H&E staining ×400). b Carcinoma cells are negative for CDX-2 (on immunohistochemistry, ×100). c Carcinoma cells are positive for CD19 (on immunohistochemistry, ×100). d Carcinoma cells are positive for hepatocytes (on immunohistochemistry, ×100)
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC5016489&req=5

Fig2: a Microscopic findings of the S2 tumor show moderately differentiated intrahepatic cholangiocarcinoma (H&E staining ×400). b Carcinoma cells are negative for CDX-2 (on immunohistochemistry, ×100). c Carcinoma cells are positive for CD19 (on immunohistochemistry, ×100). d Carcinoma cells are positive for hepatocytes (on immunohistochemistry, ×100)
Mentions: We assumed the neoadjuvant chemotherapy was not effective for the S2 lesion, so we decided to perform an extended left hepatectomy. The images of the tumor are shown in Fig. 1, and the clinical course is summarized in Table 1. To our surprise, pathological examination showed intrahepatic cholangiocarcinoma (ICC), moderately differentiated, 55 mm × 50 mm × 40 mm, s1, ne1, vp1, vv1, va0, b1. The carcinoma cells were positive for CD10 and CD19 and negative for hepatocyte, glypican 3, CK7, and CDX2 (Fig. 2). In the segments of hepatic tissue, no metastatic adenocarcinoma was found. According to the TNM classification, the pathological stage of the ICC was IVa (T4N0M0). The postoperative course was uneventful, and he was discharged on the 12th postoperative day.Table 1

View Article: PubMed Central - PubMed

ABSTRACT

Background: We experience many cases of liver metastasis from colorectal cancer, but synchronous occurrence of intrahepatic cholangiocarcinoma (ICC) and liver metastasis from a rectal cancer is extremely rare. We herein report a case of ICC coinciding with a liver metastasis from a known rectal carcinoma.

Case presentation: A 68-year-old man was referred to our hospital for investigation of multiple liver tumors. Total colonoscopy and computed tomography (CT) revealed a rectal carcinoma, coinciding with liver metastasis. He was planned to receive chemotherapy following rectal resection. During chemotherapy for the rectal cancer, one of the liver tumors gradually grew after first shrinking. The following hepatectomy revealed the presence of intrahepatic cholangiocarcinoma (ICC). Despite intensive chemotherapy for the ICC, he passed away 6 months after the hepatectomy.

Conclusions: We should also suspect the possibility of multiple primary cancers, even if the patient has a history of cancer that is likely to cause metastatic lesions. When simultaneous neoplasms are diagnosed, systematic treatment should be targeted to the tumor with the worst prognosis.

No MeSH data available.


Related in: MedlinePlus