“…Twenty-three (45%) of the 51 patients with hepatobiliary MS presented with isolated MS, either on presentation or at relapse [9,17,24,26,27,30,33,34,40,41,42,44,45,46,48,49,50,51,52,53,54,57]; 7 of them developed systemic AML within a period of 1-16 months [9,17,26,27,41,48,51] (table 1). Four of these 7 patients underwent surgery at the time of MS diagnosis, followed by chemotherapy after the development of systemic AML [9,27,41,48], with a few sustainable remissions [27,41,48]. Of 8 patients with no prior or eventual diagnosis of BM disease [24,30,40,42,50,53,54], most had upfront resections due to preoperative diagnoses of solid tumor malignancies, followed by chemotherapy; 5 remained in remission at the time of reports [24,30,40,42,50].…”