Humerus pathological fracture revealing biliary carcinoma

Lahrach, K.; Chbani, B.; Amar, F.; Bennani, Amal; Marzouki, A.; Boutayeb, F.

doi:10.1016/j.otsr.2010.05.011

Cited by 10 publications

(7 citation statements)

References 8 publications

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“…The patient was managed with a combination of bisphosphonates, radiotherapy and chemotherapy. The case of a man aged 58 years with a low-energy proximal humerus fracture was reported by Lahrach et al 6 Pathology from theatre revealed metastatic CCA, confirmed via a CT scan, with the patient dying 3 months later. A woman aged 75 years was presented by Karanjia et al 8.…”

Section: Discussionmentioning

confidence: 88%

Rare progression of cholangiocarcinoma: distal femoral metastasis

MacKenzie¹,

Goffin

Rankin

et al. 2017

BMJ Case Reports

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Cholangiocarcinoma (CCA) is a rare cancer of the bile duct epithelial cells, with metastases to long bones rarely reported. We present the case of a woman aged 61 years, diagnosed with CCA 6 years previously. She presented with right thigh discomfort, rapidly progressing to immobility with severe pain. Radiological investigations revealed a lytic lesion in her right distal femur, most likely a metastatic deposit, at high risk of pathological fracture. This was managed with an en bloc resection and implantation of a distal femoral replacement. Pathology specimens from theatre confirmed metastatic CCA. Despite sustaining a subsequent fractured neck of femur on the operative side, she recovered well from surgery, with minimal pain and improved mobility on discharge. She restarted palliative chemotherapy. This case illustrates the option of definitive major surgery for the management of metastatic bone disease. As in this case, this can lead to improved symptom control and quality of remaining life.

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Section: Discussionmentioning

confidence: 88%

Rare progression of cholangiocarcinoma: distal femoral metastasis

MacKenzie¹,

Goffin

Rankin

et al. 2017

BMJ Case Reports

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“…Only five cases of metastasis to the appendicular skeleton from CCA have been reported in the literature to date ( Table I). The most commonly reported sites of bone metastasis are the humerus, fibula and femur (8)(9)(10)(11)(12). To the best of our knowledge, this is the first report of a scapular metastasis from CCA to date.…”

Section: Discussionmentioning

confidence: 94%

Bone metastasis from cholangiocarcinoma mimicking osteosarcoma: A case report and review literature

et al. 2018

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Cholangiocarcinoma is an aggressive tumor of the hepatic biliary system and it commonly spreads to the regional lymph nodes, liver and lungs. However, bone metastasis from cholangiocarcinoma is rare compared with other tumors. We herein present the case of a 61-year-old Asian woman who presented with pain in the right scapular area. Magnetic resonance imaging revealed bone destruction and an adjacent soft tissue mass at the right scapula. The findings on computed tomography imaging were compatible with cholangiocarcinoma. Bone biopsy was performed and the diagnosis of cholangiocarcinoma with bone metastasis was confirmed. The survival time was 10 months, despite administration of palliative radiotherapy and chemotherapy. Therefore, bone metastasis from cholangiocarcinoma should be considered as a differential diagnosis in patients who present with an osteolytic bone lesion and a liver mass.

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“…There are very few publications in the literature reporting bone metastasis secondary to ICC [9][10][11][12]15]. In the literature, Carlisle et al, Lahrach et al, and Federico et al reported metastatic humeral fractures related to ICC [9][10][11]. Karanjia et al reported a case with distal fibular metastasis secondary to ICC [12].…”

Section: Discussionmentioning

confidence: 99%

“…ICC metastasis to the appendicular skeleton is extremely rare. There are very few publications in the literature on this subject [9][10][11][12]. Three of these publications were related to metastasis of the cholangiocarcinoma to the humerus and one was related to metastasis to the distal fibula.…”

Section: Introductionmentioning

confidence: 99%

Pathological Clavicle Fracture: Initial Presentation of Intrahepatic Cholangiocarcinoma

Başdelioğlu¹

2020

Cureus

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Intrahepatic cholangiocarcinoma (ICC) is the second most common tumor of the liver and accounts for 3% of all gastrointestinal tumors. Bone metastasis due to ICC is extremely rare. In this case report, a patient with pathological clavicle fracture as the first presentation of ICC was reported. A lytic mass causing a fracture in the middle part of the left clavicle was detected in a 75-year-old female patient who had sudden and severe pain in her left shoulder while getting up from her seat. Blood tests were normal except gamma-glutamyl transferase 575 U/L (0-38 U/L), alkaline phosphatase 259 U/L (0-105 U/L), direct bilirubin 5.1 mg/dl (0-0.2 mg/dl) and carcinoembryonic antigen 5.1 ng/ml (0-5 ng/ml). Positron emission tomography (PET-CT) revealed a mass in the liver and metastasis to the proximal femur and peritonei carcinomatosis. Pathological clavicle fracture was treated surgically and liver biopsy was performed by an interventional radiologist in the same session. The pathology result was reported as ICC. During the follow-up of the patient, a pathological proximal femur fracture also occurred. This fracture was also treated with total tumor hip replacement. Metastasis of ICC to the bone is extremely rare and should be kept in mind in the differential diagnosis in patients presenting with pathological bone fracture and liver mass.

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Humerus pathological fracture revealing biliary carcinoma

Cited by 10 publications

References 8 publications

Rare progression of cholangiocarcinoma: distal femoral metastasis

Rare progression of cholangiocarcinoma: distal femoral metastasis

Bone metastasis from cholangiocarcinoma mimicking osteosarcoma: A case report and review literature

Pathological Clavicle Fracture: Initial Presentation of Intrahepatic Cholangiocarcinoma

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