Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2020; 8(1): 208-216
Published online Jan 6, 2020. doi: 10.12998/wjcc.v8.i1.208
Sarcomatoid intrahepatic cholangiocarcinoma mimicking liver abscess: A case report
Yan Wang, Jia-Lei Ming, Xing-Yu Ren, Lu Qiu, Li-Juan Zhou, Shu-Dong Yang, Xiang-Ming Fang
Yan Wang, Jia-Lei Ming, Xing-Yu Ren, Lu Qiu, Li-Juan Zhou, Xiang-Ming Fang, Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
Shu-Dong Yang, Department of Pathology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
Author contributions: Wang Y designed the work, analyzed and interpreted the data and prepared the manuscript; Ming JL, Ren XY, Qiu L and Zhou LJ collected clinical data and edited the manuscript; Yang SD analyzed the pathological data; Fang XM was responsible for revision of the manuscript. All authors read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81271629; Medical Innovation Team of Wuxi City, No. CXTD002.
Informed consent statement: This report was approved by the ethics committee and the patients provided written informed consent.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
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/
Corresponding author: Xiang-Ming Fang, MD, PhD, Chief Doctor, Instructor, Professor, Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, No. 299 Qingyang Road, Wuxi 214023, Jiangsu Province, China. xiangming_fang@njmu.edu.cn
Received: October 10, 2019
Peer-review started: October 10, 2019
First decision: November 13, 2019
Revised: November 26, 2019
Accepted: November 30, 2019
Article in press: November 30, 2019
Published online: January 6, 2020
Processing time: 88 Days and 13.1 Hours
Abstract
BACKGROUND

Sarcomatoid intrahepatic cholangiocarcinoma (SICC) is an extremely rare and highly invasive malignant tumor of the liver. To our knowledge, the imaging findings of sarcomatous cholangiocarcinoma have been rarely reported; and radiological features of this tumor mimicking liver abscess have not yet been reported.

CASE SUMMARY

We present a case of SICC mimicking liver abscess. The patient, a 43-year-old male, complained of repeated upper right abdominal discomfort and intermittent distension over a period of one month. Radiology examination revealed a huge focal lesion in the right liver. The lesion was hypointense on computed tomography with honeycomb enhancement surrounded by enhanced peripheral areas. It showed a hypo-signal on non-contrast T1-weighted images and a hyper-signal on non-contrast T2-weighted images. Radiologists diagnosed the lesion as an atypical liver abscess. The patient underwent a hepatectomy. After surgery, he survived another 2.5 mo before passing away. A search of PubMed and Google revealed 43 non-repeated cases of SICC reported in 20 published studies. The following is a short review in order to improve the diagnostic and therapeutic skills in cases of SICC.

CONCLUSION

This report presents the clinical and radiological features of SICC and imaging features which showed hypovascularity and progressive enhancement. SICC can present as a multilocular cyst on radiological images and it is necessary to distinguish this lesion from an atypical abscess. Simple surgical treatment is not the best treatment option for this disease.

Keywords: Sarcomatoid intrahepatic cholangiocarcinoma; Liver abscess; Radiological features; Case report

Core tip: Sarcomatoid intrahepatic cholangiocarcinoma (SICC) is an extremely rare and highly invasive malignant tumor of the liver. The radiological features of this lesion have been rarely reported and it is difficult to differentiate this tumor from a liver abscess. We present the clinical, radiological characteristics and treatment of a patient with SICC followed by a summary of relevant English literature regarding this condition, including a prognosis analysis of SICC.