Imaging features of bone metastases from cholangiocarcinoma

Thammaroj, Punthip; Chimcherd, Apinya; Chowchuen, Prathana; Panitchote, Anupol; Sumananont, Chat; Wongsurawat, Nantaporn

doi:10.1016/j.ejrad.2020.109118

Cited by 8 publications

(10 citation statements)

References 9 publications

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“…Bone metastases have been reported in the literature, however, these are often found in later stages of disease, at multiple vertebral levels and concurrently with other sites of metastases [5] , [6] , [7] . Bony metastases from cholangiocarcinoma typically show a mixed osteolytic/osteoblastic pattern on CT and predominantly involve the anterior spinal elements [8] . A solitary FDG-avid spinous process metastasis on presentation of cholangiocarcinoma is extremely rare.…”

Section: Discussionmentioning

confidence: 99%

Solitary 18F-fluorodeoxyglucose avid spinous process cholangiocarcinoma metastasis proven on CT guided percutaneous needle bone biopsy.

Lee

Jiang

Kang

et al. 2021

Radiology Case Reports

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A 65-year-old female with newly diagnosed cholangiocarcinoma was referred for a FDG PET/CT for initial staging. There was a region of moderate FDG avidity localizing to the hepatic hilum representing the primary site of malignancy. An unexpected moderately FDG avid focus was demonstrated in the spinous process of the T11 vertebra with no corresponding mass lesion seen on low dose CT and no evidence of distant metastatic disease elsewhere. A percutaneous CT guided needle bone biopsy was performed which confirmed a solitary T11 spinous process metastasis on histopathology.

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Section: Discussionmentioning

confidence: 99%

Solitary 18F-fluorodeoxyglucose avid spinous process cholangiocarcinoma metastasis proven on CT guided percutaneous needle bone biopsy.

Lee

Jiang

Kang

et al. 2021

Radiology Case Reports

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“…The metastatic pattern in CCA is to regional lymph nodes and then distant organs including the liver, lungs, peritoneum, and, occasionally, to the bone 3 . The prevalence of bone metastasis in CCA is very low, accounting for 1.5% to 2.0% of cases 4,5 . Most of these latter patients present with bone pain and neurological deficit which can affect both performance status and quality of life 6,7 .…”

Section: Introductionmentioning

confidence: 95%

“…Bone scintigraphy (BS) has good diagnostic accuracy for the detection of bone metastasis from various cancers with pooled sensitivity and specificity of 86% and 81%, respectively 8 . Bone metastasis from CCA commonly shows an increased uptake pattern on BS and involvement at the axial skeleton 4 . Currently, there are no standardized criteria for requesting BS in patients with CCA 9 .…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Bone Scintigraphy Positivity in Cholangiocarcinoma

Siurai

Twinprai

Theerakulpisut

et al. 2023

J Health Sci Med Res

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Objective: To examine factors associated with bone scintigraphy (BS) positivity in cases with cholangiocarcinoma (CCA) to help assess appropriate utilization of BS in CCA patients. Material and Methods: This cross-sectional study enrolled CCA patients who underwent BS for detection of bone metastasis between January 2012 and July 2020. The BS images were reviewed by two nuclear medicine physicians to assess BS positivity. Factors including tumor location, T stage, regional lymph node metastasis, other distant metastases, and serum carbohydrate antigen 19-9 (CA19-9) were evaluated. Associations between covariates and positive BS were analyzed using bivariate and multiple logistic regressions. Results: Among 158 CCA patients, 70 (44.3%), 84 (53.2%), and 4 (2.5%) had positive, negative, and equivocal BS, respectively. Of all 70 positive cases, 50 cases (71.4%) had multiple metastatic lesions. The spine was the most common metastatic site (n=55, 78.6%). After exclusion of equivocal cases, 154 were included in the regression models. In bivariate logistic regression, the factors associated with BS positivity were intrahepatic tumor location (OR=2.18, p-value=0.039) and other distant metastasis (OR=2.08, p-value=0.028). Further analysis using multiple logistic regression showed only other distant metastasis was associated with positive BS (OR=2.66, p-value=0.008). Conclusion: There was a significant association between other distant metastasis and BS positivity in CCA patients. This factor should be considered as a clinical indication for requesting BS in this group of patients.

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“…Cholangiocarcinoma (CCA) is a malignant tumor that affects various parts of the bile duct tree; it develops as a result of abnormal differentiation of the epithelial cells (1)(2)(3). In Western countries, the incidence rate of CCA is about 1-2/100,000 individuals, while in Southeast Asia, the incidence rate is 0.1-71.3/100,000 individuals per year (2). CCA progresses locally through the lymphatic system and metastasizes through the veins (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

“…In Western countries, the incidence rate of CCA is about 1-2/100,000 individuals, while in Southeast Asia, the incidence rate is 0.1-71.3/100,000 individuals per year (2). CCA progresses locally through the lymphatic system and metastasizes through the veins (1)(2)(3). Reports from the literature suggested that CCA is one of the rarest primary malignancies that metastasize to the spine, and the prevalence of spinal metastasis in patients with CCA is accounting for 4-15% (4,5).…”

Section: Introductionmentioning

confidence: 99%

A single-center 10-year retrospective study of clinical features and surgical treatment of spinal metastasis from cholangiocarcinoma

Liu¹,

Zhou²,

Wang³

et al. 2021

Ann Palliat Med

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Background: This study intends to discuss the clinical features, therapeutic strategies, and patients' prognostic features and to share our expertise in handling this entity. Current research is one of Asia's extensive MSCCA clinical studies until now.Methods: Four MSCCA patients who were operated in our hospital's bone tumor center from January 2010 to January 2020 were chosen. Our team reviewed a retrospective study of the medical history and records of surgery, imaging data, and pathology reports (both primary and metastatic spinal tumors) of all MSCCA patients. We applied two surgical therapies in this study, including open surgery and percutaneous vertebroplasty. A predetermined analysis of patients' original clinical data was performed, and regular followup was performed after the operation.Results: Of the four patients, one was male and three were female. The age ranged from 60 to 70 years.The time duration between the diagnosis of cholangiocarcinoma (CCA) and the diagnosis of spinal metastases ranged from 0 to 11 months. Spinal metastatic disease was mainly located in the thoracic spine (n=4; 100%), followed by the cervical spine (n=1; 25.0%). Postoperatively, in the four patients, the symptoms improved and the VAS score was decreased. During the follow-up visit, the progression of the local spinal tumors at the site of primary spinal surgery was detected in three patients (75.0%). Three patients died from the disease during the follow-up period, and one patient is still alive. The time ranged from 6 to 13 months for spinal surgery to the patient's death.Conclusions: Taken together, the prognosis of patients with MSCCA is poor. Surgical treatment can dramatically improve patients' quality of life and helps to extend a patient's survival. In terms of surgical treatment, appropriate surgical treatment should be selected according to the general condition of the patient and the relevant characteristics of spinal metastases.

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Imaging features of bone metastases from cholangiocarcinoma

Cited by 8 publications

References 9 publications

Solitary 18F-fluorodeoxyglucose avid spinous process cholangiocarcinoma metastasis proven on CT guided percutaneous needle bone biopsy.

Solitary 18F-fluorodeoxyglucose avid spinous process cholangiocarcinoma metastasis proven on CT guided percutaneous needle bone biopsy.

Factors Associated with Bone Scintigraphy Positivity in Cholangiocarcinoma

A single-center 10-year retrospective study of clinical features and surgical treatment of spinal metastasis from cholangiocarcinoma

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