Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2022; 10(9): 2829-2835
Published online Mar 26, 2022. doi: 10.12998/wjcc.v10.i9.2829
Sarcomatoid intrahepatic cholangiocarcinoma with good patient prognosis after treatment with Huaier granules following hepatectomy: A case report
Ji-Ye Feng, Xian-Peng Li, Zong-Yang Wu, Li-Ping Ying, Chang Xin, Zhen-Zhen Dai, Yao Shen, Yi-Feng Wu
Ji-Ye Feng, Zong-Yang Wu, Li-Ping Ying, Chang Xin, Yi-Feng Wu, Department of Hepatobiliary & Pancreas Surgery, The Affiliated People’s Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China
Xian-Peng Li, Department of Infectious Disease, The Affiliated People’s Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China
Zhen-Zhen Dai, Department of Pathology, The Affiliated People’s Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China
Yao Shen, Department of Radiology, The Affiliated People’s Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China
Author contributions: Feng JY, Li XP, Wu ZY, Ying LP, Xin C, Dai ZZ, and Sheng Y cared for the patient in question; Feng JY and Wu YF reviewed the literature, and were primarily responsible for writing the manuscript; Wu YF critically reviewed and edited the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Feng Wu, MD, PhD, Chief Doctor, Department of Hepatobiliary & Pancreas Surgery, The Affiliated People’s Hospital of Ningbo University, No. 251 Baizhang Road, Ningbo 315040, Zhejiang Province, China. wyf5495@163.com
Received: August 10, 2021
Peer-review started: August 10, 2021
First decision: December 1, 2021
Revised: December 6, 2021
Accepted: February 19, 2022
Article in press: February 19, 2022
Published online: March 26, 2022
Processing time: 224 Days and 3.5 Hours
Abstract
BACKGROUND

Sarcomatoid intrahepatic cholangiocarcinoma (SICC) is an extremely rare and highly invasive malignant tumor of the liver. The precise pathologic mechanism of SICC has not been clearly identified, and the prognosis is very poor. The effectiveness of the treatment strategy of radical hepatectomy combined with Huaier granules has not yet been reported.

CASE SUMMARY

The patient was a 69-year-old male who presented with intermittent right upper abdominal pain for one month and 4-pound weight loss before admission. Abdominal magnetic resonance imaging and magnetic resonance cholangiopancreatography showed multiple stones in the bile ducts accompanied by dilatation of the intrahepatic and extrahepatic bile ducts. The preoperative diagnoses were right intrahepatic bile duct stones and extrahepatic bile duct stones; thus, surgical resection was performed. Choledochoscopy showed that the bile duct wall of the right anterior lobe was thickened, and a mass was visible in the duct. Then, a biopsy was performed, and rapid frozen-section biopsy analysis indicated that the tumor was malignant. The final diagnosis was SICC (T1aN0M0). Huaier granules were taken by the patient as anticancer therapy after surgery. The patient attended follow-up for 72 mo with no tumor recurrence or metastasis.

CONCLUSION

Sarcomatous intrahepatic cholangiocarcinoma is an extremely rare, aggressive malignancy, and the diagnostic gold standard is pathological diagnosis. We reported the first case of successful treatment with Huaier granules as anticancer therapy after surgery, which indicated that Huaier granules are safe and effective. Further studies are needed to study the anticancer molecular mechanisms of Huaier granules in sarcomatous intrahepatic cholangiocarcinoma.

Keywords: Sarcomatous intrahepatic cholangiocarcinoma; Hepatectomy; Huaier granules; Diagnose; Therapy; Case report

Core Tip: Sarcomatoid intrahepatic cholangiocarcinoma (SICC) is an extremely rare and highly invasive malignant tumor of the liver. The precise pathologic mechanism of SICC has not been clearly identified, and the prognosis is very poor. The effectiveness of the treatment strategy of radical hepatectomy combined with Huaier granules has not yet been reported. A 69-year-old male with long-term use of Huaier granules for anticancer therapy postoperation achieved long-term survival with no tumor recurrence or metastasis. We reported the first case of successful treatment with Huaier granules as an adjuvant treatment after surgery and demonstrated that Huaier granules are safe and effective.