Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 14, 2006; 12(30): 4918-4921
Published online Aug 14, 2006. doi: 10.3748/wjg.v12.i30.4918
A case of mucin producing liver metastases with intrabiliary extension
Hirotaka Tokai, Yujo Kawashita, Susumu Eguchi, Yukio Kamohara, Mitsuhisa Takatsuki, Sadayuki Okudaira, Yoshitsugu Tajima, Tomayoshi Hayashi, Takashi Kanematsu
Hirotaka Tokai, Yujo Kawashita, Susumu Eguchi, Yukio Kamohara, Mitsuhisa Takatsuki, Sadayuki Okudaira, Yoshitsugu Tajima, Takashi Kanematsu, Department of Transplantation and Digestive Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
Tomayoshi Hayashi, Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Hirotaka Tokai, MD, Department of Transplantation and Digestive Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8051, Japan. h-tokai@cj8.so-net.ne.jp
Telephone: +81-95-8497316 Fax: +81-95-8497319
Received: March 23, 2006
Revised: April 11, 2006
Accepted: April 21, 2006
Published online: August 14, 2006
Abstract

A 75-year-old man was admitted to our hospital with a diagnosis of liver metastases from colon cancer. He underwent right hemicolectomy for cecal cancer eight years ago, and had a metastatic liver tumor in segment 8 (S8), which was surgically resected about 4 years after the initial operation. Histopathological examination of the resected specimens from both operations revealed a well-differentiated adenocarcinoma with mucinous carcinoma. Four months after the second operation, computed tomography demonstrated a low-density lesion at the cut surface of the remnant liver. Although it was considered to be a postoperative collection of inflammatory fluid, it formed a cystic configuration and increased in size to approximately 5 cm in diameter. With a tentative diagnosis of a recurrence of metastatic cancer, partial hepatectomy of S8 was performed. Histological examination of the resected specimens also revealed mucinous adenocarcinoma, which had invaded into the biliary ducts, replacing and extending along its epithelium. Immunohistochemically, the tumor cells were positive for cytokeratin (CK) 20, but negative for CK7. Therefore, the tumor was diagnosed as a metastatic adenocarcinoma from colonic cancer. Liver metastases of colorectal adenocarcinoma sometimes invade the Glisson’s triad and grow along the biliary ducts.

Keywords: Liver metastases, Mucin, Intrabiliary extension, Cytokeratin 7, Cytokeratin 20