Endobiliary Metastasis from Rectal Cancer Mimicking Intrahepatic Cholangiocarcinoma: A Case Report and Review of Literature

Seshadri, Ramakrishnan Ayloor; Majhi, Urmila

doi:10.1007/s12029-009-9115-6

Cited by 15 publications

(13 citation statements)

References 16 publications

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“…In one patient with an intraductal colorectal metastasis, the tumor cells were CK7 negative but CK20 positive, supporting the immunophenotype of colorectal adenocarcinoma (Uehara et al 2004;Kayashima et al 2008;Seshadri and Majhi 2009;Wakai et al 2011) and rendering cholangiocarcinoma much less likely (Tot 1999;Rullier et al 2000). There are, however, certain differences in expression pattern between primary and secondary tumors.…”

Section: Histopathologymentioning

confidence: 66%

“…Adenocarcinoma metastasis with intraductal growth closely mimics intrahepatic cholangiocarcinoma radiologically, macroscopically, and histologically (Riopel et al 1997;Wenzel et al 2003;Colagrande et al 2004;Seshadri and Majhi 2009). Part of intraductally growing CRC metastases showed marked mucin production (Tokai et al 2006), a feature that may suggest primary intraductal mucinous tumors.…”

Section: Differential Diagnosismentioning

confidence: 98%

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Metastatic Liver Disease: Colorectal Carcinomas

Zimmermann

2016

Tumors and Tumor-Like Lesions of the Hepatobiliary Tract

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Section: Histopathologymentioning

confidence: 66%

Section: Differential Diagnosismentioning

confidence: 98%

Metastatic Liver Disease: Colorectal Carcinomas

Zimmermann

2016

Tumors and Tumor-Like Lesions of the Hepatobiliary Tract

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“…Even in this day of advanced diagnostic modalities, some cholangiocarcinomas, hepatocellular carcinomas, and benign regions could possibly be misdiagnosed as CRLM (33,34). This indicates that we might offer pointless treatment to patients with another kind of liver tumor.…”

Section: Discussionmentioning

confidence: 99%

Phase II trial of neoadjuvant chemotherapy with S-1 and oxaliplatin plus bevacizumab for colorectal liver metastasis (N-SOG 05 trial)

Mukai

Uehara

Goto

et al. 2017

Japanese Journal of Clinical Oncology

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Purpose: This Phase II trial evaluated the safety and efficacy of neoadjuvant chemotherapy (NAC) with S-1 and oxaliplatin (SOX) plus bevacizumab (Bev) in patients with colorectal liver metastasis (CRLM). Methods: Patients with initially resectable CRLM received four cycles of SOX plus Bev as NAC. We adopted the R0 resection rate as the primary endpoint, and the threshold R0 resection rate was set at 80%. Results: Between December 2010 and August 2014, 61 patients were enrolled in this study and all started NAC. The completion rate of NAC was 82.0%. Three patients (4.9%) developed severe liver dysfunction caused by NAC and one patient finally decided against resection. Three patients (4.9%) were judged as having progressive disease during or after NAC and did not undergo liver resection. Among 57 patients who underwent liver resection after NAC, three patients were diagnosed with CRLM by pre-treatment imaging modalities and received NAC although a final pathological diagnosis was another malignant disease or benign condition. Finally, 47 of the 54 patients (87.0%) with resected CRLM achieved R0 resection. The pathological complete response rate of the 54 patients was 13.0%, and 31.5% were judged as pathological responders. However, the R0 resection rate of 77.0% in the entire cohort did not meet the endpoint. Conclusions: NAC with SOX plus Bev has an acceptable toxicity profile and achieved a satisfactory pathological response. However, accuracy of pre-operative diagnoses and liver dysfunction caused by NAC were serious problems. Easy introduction of NAC for initially resectable CRLM should not be performed.

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“…However, there have been reports of unusual cases of metastatic liver tumors from CRC that predominantly extend along the intrahepatic bile duct 2 , 3 , 4 ) . Such unusual tumors generally mimic intrahepatic cholangiocarcinoma (IHCC) clinically, radiographically, and pathologically 5 , 6 , 7 ) . Importantly, it remains unclear whether anatomical or partial hepatectomy is more suitable to treat such tumors.…”

Section: Introductionmentioning

confidence: 99%

Anatomical hepatectomy for liver metastasis from rectal adenocarcinoma presenting with intrabiliary extension: a case report

et al. 2016

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Liver metastases from colorectal carcinoma commonly form nodular lesions in the liver parenchyma. We report a case of liver metastasis from rectal adenocarcinoma that extended predominantly into the bile duct. A 62-year-old Japanese man underwent low anterior resection for rectal adenocarcinoma 9 years ago. Approximately 3 years later, he underwent radiofrequency ablation therapy for a metastatic liver tumor. Nine years after surgery, a tumor in liver segment III exhibiting intrabiliary extension was discovered; it was unclear if this was a metastatic liver tumor or intrahepatic cholangiocarcinoma. Accordingly, we performed a left hepatectomy with lymph node dissection. The tumor was negative for cytokeratins 7 and 20, and was histologically similar to the primary rectal adenocarcinoma; it was diagnosed as rectal carcinoma metastasis. The patient has survived for 3 years after the hepatic surgery, for 9 years after radiofrequency ablation therapy, and for 12 years after the primary surgery. This case shows that liver metastasis from colorectal carcinoma can present as a predominantly intrabiliary growth that mimics intrahepatic cholangiocarcinoma on imaging. Moreover, our case provides evidence for the superiority of anatomical hepatectomy over partial hepatectomy for metastatic liver tumors with intrabiliary growth arising from rectal adenocarcinomas.

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Endobiliary Metastasis from Rectal Cancer Mimicking Intrahepatic Cholangiocarcinoma: A Case Report and Review of Literature

Abstract: Endobiliary metastasis from colorectal cancer can mimic ICC, and IHC studies may be needed to differentiate the two. Identifying endobiliary metastasis can have therapeutic and prognostic implications.

Cited by 15 publications

References 16 publications

Metastatic Liver Disease: Colorectal Carcinomas

Metastatic Liver Disease: Colorectal Carcinomas

Phase II trial of neoadjuvant chemotherapy with S-1 and oxaliplatin plus bevacizumab for colorectal liver metastasis (N-SOG 05 trial)

Anatomical hepatectomy for liver metastasis from rectal adenocarcinoma presenting with intrabiliary extension: a case report

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