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Case Reports
, 97 (51), e13751

Successful Treatment of Colorectal Liver Metastasis Harboring Intrahepatic Cholangiocarcinoma: A Case Report

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Case Reports

Successful Treatment of Colorectal Liver Metastasis Harboring Intrahepatic Cholangiocarcinoma: A Case Report

Xiaofei Cheng et al. Medicine (Baltimore).

Abstract

Rationale: Colorectal liver metastasis develops in 50% of patients diagnosed with colorectal cancer, whereas concurrent intrahepatic cholangiocarcinoma (ICC) and colorectal liver metastases is extremely rare.

Patient concerns: A 72-year-old man was referred to our hospital complaining of abdominal discomfort, diarrhea, and weakness over the last month.

Diagnoses: Colorectal liver metastases concurrent intrahepatic cholangiocarcinoma (ICC).

Interventions: The patient was treated with mFOLFOX6 (5-fluorouracil 2400 mg/m, leucovorin 400 mg/m, and oxaliplatin 85 mg/m) plus bevacizumab 5 mg/kg every 2 weeks for 2 months. However, chemotherapy was not effective for the liver S3 lesion in our case. The possibility of ICC was considered based on the multidisciplinary team (MDT) mode, together with an anomalous increase in cancer antigen 19-9 and a history of hepatolithiasis.

Outcomes: Simultaneous resection of the colon cancer and liver tumors was performed at 6 weeks after discontinuing bevacizumab. Colorectal liver metastases concurrent ICC was confirmed by postoperative pathology. The patient's disease-free survival time is currently >14 months.

Lessons: This is the first case report of the diagnosis and timely treatment of colorectal liver metastases harboring ICC. These results suggest that multiple primary tumors should be considered as a differential diagnosis when imaging or laboratory test results are abnormal.

Conflict of interest statement

The authors declare that they have no conflicts of interest concerning this article.

Figures

Figure 1
Figure 1
Computed tomography (CT) and magnetic resonance imaging (MRI) showed the liver tumor's radiographic response to chemotherapy. The liver tumor S4 to S8 had shrunk distinctly after the chemotherapy, but the S3 tumor had slightly grown on the MRI scan (1.1–1.7 cm).
Figure 2
Figure 2
(A) Microscopic findings of the S4 to S8 tumor show moderately differentiated adenocarcinoma (H&E staining ×100); (B) microscopic findings of the S3 tumor show moderately differentiated intrahepatic cholangiocarcinoma (H&E staining ×100); (C) S3 tumor carcinoma cells are positive for CK7 (on immunohistochemistry, ×100); (D) S3 tumor carcinoma cells are positive for CK19 (on immunohistochemistry, ×100).

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