Case Report
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World J Gastrointest Surg. Apr 27, 2014; 6(4): 65-69
Published online Apr 27, 2014. doi: 10.4240/wjgs.v6.i4.65
Pancreatic recurrence of intrahepatic cholangiocarcinoma: Case report and review of the literature
Ismaïl Labgaa, Gonzalo Carrasco-Avino, Maria Isabel Fiel, Myron Eliot Schwartz
Ismaïl Labgaa, Myron Eliot Schwartz, Department of Surgery, Mount Sinai School of Medicine, NewYork, NY 10029, United States
Gonzalo Carrasco-Avino, Maria Isabel Fiel, Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, United States
Author contributions: Labgaa I and Schwartz ME designed the report; Schwartz ME was the attending doctor for the patient; Schwartz ME performed the surgical operations; Fiel MI and Carrasco-Avino G performed the pathological examinations; Labgaa I wrote the paper.
Correspondence to: Myron Eliot Schwartz, MD, Department of Surgery, Mount Sinai School of Medicine, RMTI Liver Surgery Program, 5 East 98th Street, 12th Floor, Box 1104 New York, NY 10029, United States. myron.schwartz@mountsinai.org
Telephone: +1-212-6598084  Fax: +1-646-5379238
Received: November 27, 2013
Revised: January 15, 2014
Accepted: March 17, 2014
Published online: April 27, 2014
Processing time: 174 Days and 4.5 Hours
Abstract

Intrahepatic cholangiocarcinomas (ICC) are malignant tumors arising from the intrahepatic bile ducts that frequently recur after resection. The main sites of recurrence are the remnant liver, lymph nodes and lungs. Metastasis to the pancreas has never been reported. This case describes a 24-year-old woman who underwent a hepatic lobectomy in 2008 for an ICC. Almost 4 years after her surgery she presented with a pancreatic mass and lung nodules. An endoscopic ultrasound guided fine needle aspiration of the pancreatic mass and a video-assisted thoracoscopic surgery resection for the lung nodules were performed for diagnostic purposes. Pathological analyses of specimens revealed recurrence of her primary ICC in both pancreas and lungs. Subsequently, the patient received systemic chemotherapy. The patient is currently off chemotherapy and remains well. Moreover, she is pregnant. This is the first report of an ICC with pancreatic metastasis.

Keywords: Intrahepatic cholangiocarcinoma; Recurrence; Liver resection; Pancreatic metastasis; Pulmonary metastasis

Core tip: Intrahepatic cholangiocarcinoma (ICC) is characterized by its high potential to metastasize. Most frequent sites for metastases are the remnant liver, lymph nodes and lungs. Metastasis to the pancreas has never been described. Although this may happen exceedingly rarely, hepatobiliary surgeons should be made aware that ICC can also metastasize to the pancreas.