Intrahepatic cholangiocarcinoma with bile duct tumour thrombus: a case for complete resection
DOI:
https://doi.org/10.18203/2349-2902.isj20222601Keywords:
Intrahepatic cholangiocarcinoma, Bile duct tumor thrombus, Left hepatectomyAbstract
Intrahepatic cholangiocarcinoma (ICC), which is ordinarily a very invasive tumor and often takes a rapid and fatal course, sometimes shows macroscopic intra bile duct extension. We present a case of a 45-year-old Indian gentleman who presented with jaundice. Further evaluation with contrast enhanced computed tomography (CECT) and magnetic resonance imaging (MRI) abdomen revealed mass lesion in segment 4 of liver with extension into the bile duct. A formal left hepatectomy with gall bladder and bile duct tumour thrombus extraction with bile duct excision followed by a Roux-en-Y hepaticojejunostomy was performed. Intra bile duct growth of ICC may reflect indolent biological behavior and thus warrants an aggressive surgical approach, which appears to give a good prognosis.
References
Iyomasa S, Nimura Y, Kamiya J, Maeda S, Kondo S, Yasui A, et al. Cholangiocellular carcinoma in the caudate lobe with intraluminal growth in the extrahepatic bile duct. Hepato-Gastroenterol. 1992;39:570-3.
Styne P, Warren GH, Kumpe DA, Halgrimson C, Kern Jr F. Obstructive cholangitis secondary to mucus secreted by a solitary papillary bile duct tumor. Gastroenterology. 1986;90:748-53.
Nakanuma Y, Curado MP, Franceschi S, Gores G, Paradis V, Sripa B, et al. Chapter 12: Intrahepatic cholangiocarcinoma, combined hepatocellular-cholangiocarcinoma. In: Bosman FT, Carneiro F, Hruban RH, Theise ND, editors. Classification of tumours of the digestive system. 4th edition. IARC: Lyon. 2010;217-25.
Vijgen S, Terris B, Rubbia-Brandt L. Pathology of intrahepatic cholangiocarcinoma. Hepatobiliary Surg Nutr. 2017;6:22-34.
Stavraka C, Rush H, Ross P. Combined hepatocellular cholangiocarcinoma (cHCC-CC): an update of genetics, molecular biology, and therapeutic interventions. J Hepatocell Carcinoma. 2019;6:11-21.
Paradis V, Fukayama M, Park YN, Schirmacher P. Chapter 8: Tumours of the liver and intrahepatic bile ducts. In: Nagtegaal ID, Odze RD, Klimstra D, Paradis V, Rugge M, Schirmacher P, et al, editors. WHO classification of tumours: digestive system tumours. IARC: Lyon. 2019;214-6.
Kambakamba P, DeOliveira ML. Perihilar cholangiocarcinoma: paradigms of surgical management. Am J Surg. 2014;208:563-70.
Blechacz B. Cholangiocarcinoma: current knowledge and new developments. Gut Liver. 2017;11:13-26.
Roslyn JJ, Kuchenbecker S, Longmire WP, Tompkins RK. Floating tumor debris: a cause of intermittent biliary obstruction. Arch Surg. 1984;119:1312-5.
Edmondson HA. Tumor of the liver and intrahepatic bile ducts. In: Atlas of Tumor Pathology, Series 7, Fascicle 25. Washington, DC: Armed Forces Institute of Pathology. 1958;109.
Iyomasa S, Nimura Y, Kamiya J, Maeda S, Kondo S, Yasui A, et al. Cholangiocellular carcinoma in the caudate lobe with intraluminal growth in the extrahepatic bile duct. Hepato-Gastroenterology. 1992;39:570-3.
Styne P, Warren GH, Kumpe DA, Halgrimson C, Kern F. Obstructive cholangitis secondary to mucus secreted by a solitary papillary bile duct tumor. Gastroenterology. 1986;90:748-53.
Capizzi PJ, Rosen CB, Nagorney DM. Intermittent jaundice by tumor emboli from intrahepatic cholangiocarcinoma. Gastroenterology. 1992;103;1669-73.
Komuta M, Spee B, Vander Borght S, et al. Clinicopathological study on cholangiolocellular carcinoma suggesting hepatic pro- genitor cell origin. Hepatology. 2008;47:1544-56.
Nanashima A, Imamura N, Sumida Y, Hiyoshi M, Hamada T, Nagayasu T, et al. Clinicopathological aspects and diagnostic problems in patients with intraductal papillary neoplasm of the bile duct. Anticancer Res. 2018;38:2343-52.
Yamamoto Y, Shimada K, Sakamoto Y, Esaki M, Nara S, Ban D, et al. Clinicopathological characteristics of intrahepatic cholangiocellular carcinoma presenting intrahepatic bile duct growth. J Surg Oncol. 2009;99:161-5.
Rockwell G, Barker JW, Lasersohn JT. Cholangiocarcinoma of the liver: Case report with seven-year survival, with review of the literature on primary liver tumors and hepatic resections. Cancer. 1966;19:1177-84.
Sanguily J, Calderin VO. Partial resection of the liver for primary cholangiocarcinoma: presentation of a successful case. Am J Surg. 1974;128:603-7.
Kawarada Y, Mizumoto R. Cholangiocellular carcinoma of the liver. Am J Surg. 1984;147:354-9.
Chen M-F, Jan Y-Y, Wang C-S, Jeng L-B, Hwang T-L. Clinical experience in 20 hepatic resections for peripheral cholangiocarcinoma. Cancer. 1989;64:2226-32.
