Liver metastasis from colorectal cancer is a common finding, but synchronous occurrence of intrahepatic cholangiocarcinoma (ICC) and colorectal cancer is extremely rare. We report a case of a 68-year-old man, diagnosed with rectal cancer and in whom, the staging CT scan showed a hepatic metastasis with intra-ductal hilar lesion. Biopsy of the hepatic lesion revealed an infiltrating cholangiocarcinoma. And the final diagnosis was a klatskin tumor coinciding with a rectal carcinoma. The possibility of multiple primary cancers should always be suspected in every oncologic patient even if the cancer is known to have metastatic lesions.
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