Abstract
We report a case of intestinal obstruction caused by metastasis that manifested 6 years after surgery for intrahepatic cholangiocarcinoma (ICC). The patient, a 57-year-old man, had undergone resection of the hepatic left lobe, Spiegel lobe, and extrahepatic bile duct, following which histopathological examination had confirmed the diagnosis of ICC and that the resection margins were free from disease. There had been no signs of recurrence until an increase in the CA19-9 level was detected 6 years later. Colonoscopy revealed an ulcer-like lesion and stenosis at the level of the hepatic flexure. The patient was subsequently admitted to our hospital with abdominal pain and underwent right hemicolectomy with partial resection of hepatic segment V. Based on the immunohistological finding that the expression pattern of cytokeratins and mucins was consistent with ICC origin rather than colon cancer origin, we diagnosed colon metastasis from ICC.
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References
Uenishi T, Kubo S, Yamazaki O, Yamada T, Sasaki Y, Nagano H, et al. Indications for surgical treatment of intrahepatic cholangiocarcinoma with lymph node metastases. J Hepatobiliary Pancreat Surg. 2008;15:417–22 (in eng).
Hayashi H, Tani T, Tajima H, Shoji Y, Terai S, Onishi I, et al. Small intestinal metastasis from intrahepatic cholangiocarcinoma: report of a case. Surg Today. 2011;41:859–64 (in eng).
Weber SM, Jarnagin WR, Klimstra D, DeMatteo RP, Fong Y, Blumgart LH. Intrahepatic cholangiocarcinoma: resectability, recurrence pattern, and outcomes. J Am Coll Surg. 2001;193:384–91 (in eng).
Yamamoto M, Takasaki K, Otsubo T, Katsuragawa H, Katagiri S. Recurrence after surgical resection of intrahepatic cholangiocarcinoma. J Hepatobiliary Pancreat Surg. 2001;8:154–7 (in eng).
Miwa S, Miyagawa S, Kobayashi A, Akahane Y, Nakata T, Mihara M, et al. Predictive factors for intrahepatic cholangiocarcinoma recurrence in the liver following surgery. J Gastroenterol. 2006;41:893–900 (in eng).
Wakahara T, Tsukamoto T, Kitamura S, Watanabe A, Tsujimura T, Nakamura Y, et al. Metastatic colon cancer from intrahepatic cholangiocarcinoma. J Hepatobiliary Pancreat Surg. 2005;12:415–8 (in eng).
Izzo F, Piccirillo M, Albino V, Botti G, Foggia M, Iodice R, et al. Case report: appearance of an intestinal metastasis from intrahepatic cholangiocarcinoma occurring 5 years after resection of the primary tumor. Eur J Gastroenterol Hepatol. 2010;22:892–4 (in eng).
Yamamoto M, Takasaki K, Yoshikawa T, Ueno K, Nakano M. Does gross appearance indicate prognosis in intrahepatic cholangiocarcinoma? J Surg Oncol. 1998;69:162–7 (in eng).
Kitagawa D, Taketomi A, Aishima S, Kuroda Y, Gion T, Shirabe K, et al. Recurrence of intrahepatic cholangiocarcinoma nine years after surgical resection. Hepatogastroenterology. 2008;55:1085–8 (in eng).
Nakamura H, Fu K, Fukui H, Hurlstone DP, Kaji Y, Ishikawa T, et al. A solitary colonic metastasis from gastric cancer detected at an early stage. Gastrointest Endosc. 2008;67:1000–4 (in eng).
Weng MW, Wang HC, Chiou JC, Lin SL, Lai RS. Colonic metastasis from a primary adenocarcinoma of the lung presenting with acute abdominal pain: a case report. Kaohsiung J Med Sci. 2010;26:40–4 (in eng).
Jadav AM, Thrumurthy SG, DeSousa BA. Solitary colonic metastasis from renal cell carcinoma presenting as a surgical emergency nine years post-nephrectomy. World J Surg Oncol. 2010;8:54 (in eng).
Iwase H, Indo T, Shimada M, Tsuzuki T, Nakarai K, Kaida S, et al. Esophageal cancer with colonic metastasis successfully treated by chemoradiotherapy followed by chemotherapy with S-1 and cisplatin. Int J Clin Oncol. 2004;9:398–402 (in eng).
Nozaki Y, Kobayashi N, Shimamura T, Akiyama T, Inamori M, Iida H, et al. Colonic metastasis from hepatocellular carcinoma: manifested by gastrointestinal bleeding. Dig Dis Sci. 2008;53:3265–6 (in eng).
Fu K, Ikematsu H, Fujii T, Ishikawa T, Tsujinaka Y. Gastrointestinal: isolated colonic metastasis from parotid gland cancer. J Gastroenterol Hepatol. 2008;23:1308 (in eng).
Feng CL, Chou JW, Huang SF. Colonic metastasis from carcinoma of the breast presenting with colonic erosion. Endoscopy. 2009;41(Suppl 2):E276–7 (in eng).
Rubin BP, Skarin AT, Pisick E, Rizk M, Salgia R. Use of cytokeratins 7 and 20 in determining the origin of metastatic carcinoma of unknown primary, with special emphasis on lung cancer. Eur J Cancer Prev. 2001;10:77–82 (in eng).
Tot T. Cytokeratins 20 and 7 as biomarkers: usefulness in discriminating primary from metastatic adenocarcinoma. Eur J Cancer. 2002;38:758–63 (in eng).
Lee MJ, Lee HS, Kim WH, Choi Y, Yang M. Expression of mucins and cytokeratins in primary carcinomas of the digestive system. Mod Pathol. 2003;16:403–10 (in eng).
Park SY, Kim BH, Kim JH, Lee S, Kang GH. Panels of immunohistochemical markers help determine primary sites of metastatic adenocarcinoma. Arch Pathol Lab Med. 2007;131:1561–7 (in eng).
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Kazuaki Tokodai and his co-authors have no conflict of interest.
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Tokodai, K., Kawagishi, N., Miyagi, S. et al. Intestinal obstruction caused by colonic metastasis from intrahepatic cholangiocarcinoma 6 years after removal of the primary tumor: report of a case. Surg Today 42, 797–800 (2012). https://doi.org/10.1007/s00595-012-0138-4
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DOI: https://doi.org/10.1007/s00595-012-0138-4