A case of intrahepatic cholangiocarcinoma that was difficult to diagnose prior to surgery: A case report

Nagata,Ken; Einama,Takahiro; Kimura,Akifumi; Murayama,Michinori; Takeo,Hiroteru; Nishikawa,Makoto; Hoshikawa,Mayumi; Noro,Takuji; Ogata,Sho; Aosasa,Suefumi; Kajiwara,Yoshiki; Shinto,Eiji; Yaguchi,Yoshihisa; Hiraki,Shuichi; Tsujimoto,Hironori; Hase,Kazuo; Ueno,Hideki; Yamamoto,Junji

doi:10.3892/ol.2018.9666

A case of intrahepatic cholangiocarcinoma that was difficult to diagnose prior to surgery: A case report

Authors:
- Ken Nagata
- Takahiro Einama
- Akifumi Kimura
- Michinori Murayama
- Hiroteru Takeo
- Makoto Nishikawa
- Mayumi Hoshikawa
- Takuji Noro
- Sho Ogata
- Suefumi Aosasa
- Yoshiki Kajiwara
- Eiji Shinto
- Yoshihisa Yaguchi
- Shuichi Hiraki
- Hironori Tsujimoto
- Kazuo Hase
- Hideki Ueno
- Junji Yamamoto
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Affiliations: Department of Surgery, National Defense Medical College, Tokorozawa, Saitama 359‑8513, Japan, Department of Surgery, Self‑Defense Forces Central Hospital, Setagaya, Tokyo 154‑8532, Japan, Department of Diagnostic Pathology, Self‑Defense Forces Central Hospital, Setagaya, Tokyo 154‑8532, Japan, Department of Pathology, National Defense Medical College, Tokorozawa, Saitama 359‑0042, Japan
Published online on: November 5, 2018 https://doi.org/10.3892/ol.2018.9666
Pages: 823-830
Copyright: © Nagata et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present study reports a case of mass‑forming intrahepatic cholangiocarcinoma (ICC), which mimicked cholangiocellular carcinoma (CoCC) during imaging and a needle biopsy examination. A 51‑year‑old female with no relevant medical history was referred to the National Defense Medical College hospital with an intrahepatic tumor. Computed tomography demonstrated non‑homogeneous enhancement in the early arterial phase and persistent enhancement in the portal and equilibrium phases, together with notable swelling of the para‑aortic lymph nodes. Gadolinium‑ethoxybenzyl diethylenetriamine‑pentaacetic acid‑enhanced magnetic resonance imaging revealed low signal intensity in the hepatobiliary phase. The liver tumor and lymph nodes exhibited increased radiotracer uptake (maximum standardized uptake value=14.0) with positron emission tomography. A histological examination of a percutaneous needle biopsy specimen of the liver tumor indicated a diagnosis of CoCC. The patient underwent left hepatectomy and lymphadenectomy. The surgical specimen contained a poorly differentiated adenocarcinoma with anaplastic changes, which was immunohistochemically positive for epithelial membrane antigen (at the luminal membrane), cytokeratins 7 and 19, and negative for α‑fetoprotein, hepatocyte‑specific antigen, cluster of differentiation 56 and KIT. Based on these histopathological and immunohistochemical findings, the patient was diagnosed with ICC.

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