Intrahepatic cholangiocarcinoma coinciding with a liver metastasis from a rectal carcinoma: a case report

Abstract

BackgroundWe experience many cases of liver metastasis from colorectal cancer, but synchronous occurrence of intrahepatic cholangiocarcinoma (ICC) and liver metastasis from a rectal cancer is extremely rare. We herein report a case of ICC coinciding with a liver metastasis from a known rectal carcinoma.Case presentationA 68-year-old man was referred to our hospital for investigation of multiple liver tumors. Total colonoscopy and computed tomography (CT) revealed a rectal carcinoma, coinciding with liver metastasis. He was planned to receive chemotherapy following rectal resection. During chemotherapy for the rectal cancer, one of the liver tumors gradually grew after first shrinking. The following hepatectomy revealed the presence of intrahepatic cholangiocarcinoma (ICC). Despite intensive chemotherapy for the ICC, he passed away 6 months after the hepatectomy.ConclusionsWe should also suspect the possibility of multiple primary cancers, even if the patient has a history of cancer that is likely to cause metastatic lesions. When simultaneous neoplasms are diagnosed, systematic treatment should be targeted to the tumor with the worst prognosis.

Probe electrospray ionization mass spectrometry‐based rapid diagnosis of liver tumors

“…2,30 However, we often encounter difficult cases when attempting to precisely diagnose liver tumors, especially preoperatively. 19,31 For example, ICC and CRLM often show similar findings with imaging. Therefore, it could be more difficult to diagnose a liver nodule preoperatively, especially in patients with a history of colorectal cancer.…”

“…Diagnoses of liver tumors are generally made by imaging studies, such as echography (ultrasonography), computed tomography, and magnetic resonance imaging 2,30 . However, we often encounter difficult cases when attempting to precisely diagnose liver tumors, especially preoperatively 19,31 . For example, ICC and CRLM often show similar findings with imaging.…”

“…For example, ICC and CRLM often show similar findings with imaging. Therefore, it could be more difficult to diagnose a liver nodule preoperatively, especially in patients with a history of colorectal cancer 31 . The diagnostic system based on PESI‐MS that we evaluated in this study could enable us to precisely diagnose liver nodules intraoperatively and avoid unnecessary resection.…”

Successful treatment of colorectal liver metastasis harboring intrahepatic cholangiocarcinoma

“…[11] Only 2 reports are available in the literature about colorectal metastases with ICC; however, both diagnoses were delayed. [3,4]…”

“…[3] Another author reported ICC coinciding with colorectal liver metastasis, but missed the diagnosis and the best opportunity for surgery. [4] We herein report a case of concomitant colorectal liver metastases and ICC that was treated successfully. We successfully resected colorectal liver metastases and the ICC based on multidisciplinary team (MDT) mode, where one of liver tumors developed gradually during chemotherapy.…”