Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2021; 9(6): 1469-1474
Published online Feb 26, 2021. doi: 10.12998/wjcc.v9.i6.1469
Intrahepatic cholangiocarcinoma is more complex than we thought: A case report
Jian-Ting Zeng, Jie-Feng Zhang, Yu Wang, Zhou Qing, Zhen-Hua Luo, Yan-Lin Zhang, Yi Zhang, Xian-Zhang Luo
Jian-Ting Zeng, Zhou Qing, Zhen-Hua Luo, Yan-Lin Zhang, Yi Zhang, Xian-Zhang Luo, Key Laboratory for Biorheological Science and Technology of Ministry of Education, Chongqing University, Chongqing University Cancer Hospital, Chongqing 400030, China
Jie-Feng Zhang, Yu Wang, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing 400030, China
Author contributions: Zhang JF was the patient’s surgeon; Qing Z and Luo ZH conducted research on the concept and design; Luo XZ and Zeng JT drafted the manuscript; Wang Y and Zhang YL critically revised the manuscript for important intellectual content; Zhang Y supervised the study; All authors approved the final 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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xian-Zhang Luo, MD, Doctor, Key Laboratory for Biorheological Science and Technology of Ministry of Education, Chongqing University, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Shapingba District, Chongqing 400030, China. heroluoxz@sina.com
Received: November 9, 2020
Peer-review started: November 9, 2020
First decision: December 3, 2020
Revised: December 15, 2020
Accepted: January 6, 2021
Article in press: January 6, 2021
Published online: February 26, 2021
Abstract
BACKGROUND

Brain metastasis from intrahepatic cholangiocarcinoma is rare. To the best of our knowledge, only a few cases have been reported. The biological behavior was complex, and treatment requires further investigation.

CASE SUMMARY

A 62-year-old woman complained of left limb weakness. Abdominal computed tomography showed a 5.0 cm × 5.6 cm lesion in the left lobe of the liver. Tumor markers were normal. Serological analysis indicated absence of hepatitis virus. Brain magnetic resonance imaging revealed a 1.0 cm × 1.3 cm mass in the right frontal lobe. Intrahepatic cholangiocarcinoma with brain metastasis was diagnosed by our liver cancer multidisciplinary team. After sufficient preparation, the patient underwent partial frontal lobotomy and left hemihepatectomy. Histopathological results confirmed that both the lesions were cholangiocarcinoma. Six cycles of gemcitabine combined with S1 were administered. During a 39 mo postoperative follow-up, no sign of local recurrence or distant metastasis was observed.

CONCLUSION

This case expands our knowledge concerning the complex and heterogeneous nature of tumor metastasis.

Keywords: Intrahepatic cholangiocarcinoma, Brain metastasis, Multidisciplinary team, Synchronous brain metastasis, Case report

Core Tip: Intrahepatic cholangiocarcinoma is the second most common type of primary liver cancer, but metastasis to the brain is rare. Because of the low prevalence, the treatment and biological behavior are still unclear and require further study. In this work, we report a 62-year-old patient with intrahepatic cholangiocarcinoma with brain metastasis. Operation-based comprehensive treatment was recommended by our liver cancer multidisciplinary group. There was no local recurrence or distant metastasis after 39 mo of postoperative follow-up. We propose that each cancer patient should be treated regardless of disease stage, and a multidisciplinary team is important.