title: Distant skeletal muscle metastasis from intrahepatic cholangiocarcinoma presenting as Budd-Chiari syndrome.
abstract: Intrahepatic cholangiocarcinoma is a malignant neoplasm arising from the biliary epithelium, which frequently invades adjacent organs or metastasizes to other visceral organs such as the lungs, bones, adrenals, and brain. However, distant skeletal muscle metastasis of cholangiocarcinoma has never been described before to the best of our knowledge and, furthermore, Budd-Chiari syndrome secondary to intrahepatic cholangiocarcinoma is also extremely rare. Here we present the first case overall of distant muscle metastasis from intrahepatic cholangiocarcinoma presenting as Budd-Chiari syndrome. A 44-year-old man admitted to the hospital with complaints of abdominal distension, edema of both legs, back pain and anorexia of 30 d' duration. Computed tomography and ultrasonography-guided percutaneous muscle biopsy established intrahepatic cholangiocarcinoma with disseminated thrombosis from inferior vena cava to bilateral iliac and femoral veins, and multiple skeletal muscle metastases in bilateral buttock and erector spinal muscle.
authors.affiliation: Department of Internal Medicine, Eulji University Hospital, Seoul, Korea.
authors.forename: Oh-Sung
authors.initials: OS
authors.lastname: Kwon
authors.forename: Dae-Won
authors.initials: DW
authors.lastname: Jun
authors.forename: Sang-Heum
authors.initials: SH
authors.lastname: Kim
authors.forename: Mee-Yeon
authors.initials: MY
authors.lastname: Chung
authors.forename: Nam-In
authors.initials: NI
authors.lastname: Kim
authors.forename: Moon-Hee
authors.initials: MH
authors.lastname: Song
authors.forename: Han-Hyo
authors.initials: HH
authors.lastname: Lee
authors.forename: Seung-Hwan
authors.initials: SH
authors.lastname: Kim
authors.forename: Yoon-Ju
authors.initials: YJ
authors.lastname: Jo
authors.forename: Young-Sook
authors.initials: YS
authors.lastname: Park
authors.forename: Jong-Eun
authors.initials: JE
authors.lastname: Joo
mesh_terms: D000328:Adult; D001650:Bile Duct Neoplasms / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic; D001706:Biopsy; D006502:Budd-Chiari Syndrome / Q000175:diagnosis* / Q000473:pathology; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000556:secondary*; D003937:Diagnosis, Differential; D005268:Femoral Vein / Q000473:pathology; D006801:Humans; D007084:Iliac Vein / Q000473:pathology; D008297:Male; D019042:Muscle Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D018482:Muscle, Skeletal / Q000473:pathology; D013927:Thrombosis / Q000473:pathology