Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2015; 21(38): 10926-10930
Published online Oct 14, 2015. doi: 10.3748/wjg.v21.i38.10926
Hilar cholangiocarcinoma with intratumoral calcification: A case report
Kazuho Inoko, Takahiro Tsuchikawa, Takehiro Noji, Yo Kurashima, Yuma Ebihara, Eiji Tamoto, Toru Nakamura, Soichi Murakami, Keisuke Okamura, Toshiaki Shichinohe, Satoshi Hirano
Kazuho Inoko, Takahiro Tsuchikawa, Takehiro Noji, Yo Kurashima, Yuma Ebihara, Eiji Tamoto, Toru Nakamura, Soichi Murakami, Keisuke Okamura, Toshiaki Shichinohe, Satoshi Hirano, Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido 060-8648, Japan
Author contributions: Inoko K and Tsuchikawa T wrote the manuscript; Shichinohe T and Hirano S revised the manuscript; Okamura K, Nakamura T and Tamoto E performed the surgery; Murakami S, Ebihara Y, Kurashima Y and Noji T acquired the data.
Informed consent statement: The patient gave written informed consent before treatment.
Conflict-of-interest statement: The authors have no conflicts of interest relevant to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kazuho Inoko, MD, Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, North-15, West-7, Kita-ku, Sapporo, Hokkaido 060-8648, Japan. k.inoko@icloud.com
Telephone: +81-11-7067714 Fax: +81-11-7067158
Received: March 26, 2015
Peer-review started: March 27, 2015
First decision: April 24, 2015
Revised: May 27, 2015
Accepted: August 31, 2015
Article in press: August 31, 2015
Published online: October 14, 2015
Processing time: 202 Days and 11.5 Hours
Abstract

This report describes a rare case of hilar cholangiocarcinoma with intratumoral calcification that mimicked hepatolithiasis. A 73-year-old man presented to a local hospital with a calcified lesion in the hepatic hilum. At first, hepatolithiasis was diagnosed, and he underwent endoscopic stone extraction via the trans-papillary route. This treatment strategy failed due to biliary stricture. He was referred to our hospital, and further examination suggested the existence of cholangiocarcinoma. He underwent left hepatectomy with caudate lobectomy and extrahepatic bile duct resection. Pathological examination revealed hilar cholangiocarcinoma with intratumoral calcification, while no stones were found. To the best of our knowledge, only one case of calcified hilar cholangiocarcinoma has been previously reported in the literature. Here, we report a rare case of calcified hilar cholangiocarcinoma and reveal its clinicopathologic features.

Keywords: Cholangiocarcinoma; Klatskin tumor; Calcification; Lithiasis; Differentiation

Core tip: Our report describes an extremely rare case of hilar cholangiocarcinoma with intratumoral calcification. Imaging findings of this case were confusingly similar to those of hepatolithiasis, and it was extremely difficult to make an accurate diagnosis using available radiological findings. We performed pathological examination and observed hilar cholangiocarcinoma with intratumoral calcification. We herein report a rare case of calcified hilar cholangiocarcinoma and reveal its clinicopathologic features.