Simultaneously metastatic cholangiocarcinoma and small intestine cancer from breast cancer misdiagnosed as primary cholangiocarcinoma: A case report

Figure 1 Imaging findings of the bile duct neoplasms. A: Magnetic resonance imaging (MRI) of the abdomen and magnetic resonance cholangiopancreatography (MRCP) showed an occupying lesion in the common bile duct; B: MRI of the abdomen and MRCP showed significant stenosis of the bile duct, and dilatation of the intrahepatic and extrahepatic bile ducts. The red arrow points to the location of the bile duct tumor.

Figure 2 Immunohistochemical and histological features of metastatic cholangiocarcinoma and small intestine cancer from breast cancer. A: Hematoxylin and eosin (H&E) staining showed that cancer cells infiltrated the entire intestinal wall, (40 ×); B: H&E staining showed that cancer cells infiltrated the glandular duct of the bile duct (100 ×); C-J: Immunohistochemical staining showed negative expression of caudal-related homeobox transcription factor 2 (CDX-2) (C) and villin (E) in metastatic cholangiocarcinoma. Immunohistochemical staining showed negative expression of CDX-2 (D) and villin (F) in the metastatic small intestine tumor. Immunohistochemical staining showed positive gross cystic disease fluid protein 15 (GCDFP-15) (G) and expression of GATA binding protein-3 (GATA3) (I) in metastatic cholangiocarcinoma. Immunohistochemical staining showed positive GCDFP-15 (H) and expression of GATA3 (J) in the metastatic small intestine tumor; K: Tumor cells were detected in the hydrothorax and ascites.