A colonic metastasis from extrahepatic cholangiocarcinoma after removal of primary tumor: a case report and literature review

Abstract

Metastatic cholangiocarcinoma (CCA) to the gastrointestinal tracts has rarely been described in the literature. We report a 54-year-old male patient with radical resection of an extrahepatic CCA who underwent uncommon metastatic pattern. After a recurrence-free period of 2 years, an elevated CA19-9 initiated a CT scan, showing a tumor at the junction of rectum and sigmoid with enlarged lymph nodes around colon, mimicking a primary colon cancer. Histological diagnosis was adenocarcinoma, and the patient was treated with surgery as a primary colon cancer, but post-operative immunohistochemistry revealed the same pattern as the CCA. As colon is not the common organ for distant spread that makes some challenge to distinguish the colonic metastatic CCA between primary colon carcinoma. Biomarkers (CA 19-9), immunohistological and pathological features play an important role in distinguishing CCA from primary colon cancer. This case taught us a lesson how cancers can spread to unusual sites and mimic other tumor types, that may change the treatment and prognostication significantly.

Adoption of Artificial Intelligence (AI)-Based Computerized Tomography (CT) Evaluation of Comprehensive Nursing in the Operation Room in Laparoscopy-Guided Radical Surgery of Colon Cancer

“…Besides, considerate and comprehensive nursing is required for the adoption of this technology. Based on routine nursing, comprehensive nursing in operation room is helpful for psychological intervention and rehabilitation guidance for patients and can meet the current clinical nursing needs [ 21 , 22 ]. Hence, a total of 100 patients who were diagnosed with colon cancer after enteroscopy examination and received laparoscopic radical surgery were chosen as the research objects, and they were equally divided into an observation group (comprehensive nursing) and a control group (routine nursing).…”

An overview of extrahepatic cholangiocarcinoma: from here to where?

“…Particularly, patients with unresectable advanced eCCA and liver metastases may benefit from chemotherapy combining gemcitabine and cisplatin or pembrolizumab and nab-paclitaxel ( 149 , 150 ). About the gastrointestinal tracts, several studies also reported colonic metastasis of eCCA ( 151 , 152 ). Rarely, distal skeletal muscle metastasis could appear in a few eCCA patients as reported ( 153 ).…”