Intraductal papillary growth of liver metastasis originating from colon carcinoma in the bile duct: report of a case.
Morphologically, liver metastases from colorectal carcinoma usually form as nodular tumor masses, whereas intraductal papillary growth in the bile duct is rare. A 65-year-old man underwent right hemicolectomy for advanced colon carcinoma, and histology of the primary carcinoma confirmed moderately differentiated adenocarcinoma with subserosal invasion, no vascular infiltration, and no lymph node metastasis. A liver tumor was found in the right paramedian Glisson pedicle and intraductal growth of cholangiocarcinoma was seen on imaging. We performed right hepatectomy and macroscopically, the resected specimen contained a growth in the bile duct lumen similar to cholangiocarcinoma. Histological examination revealed intraductal papillary proliferation of well-differentiated adenocarcinoma without vascular infiltration or lymph node metastasis in the hepatic hilum. Immunohistochemical staining revealed that the tumor cells were negative for cytokeratin-7 and positive for cytokeratin-20. Based on these findings, liver metastasis from colon carcinoma was diagnosed. Liver metastasis from colorectal carcinoma rarely arises as intraductal papillary growth in the bile duct, but the possibility of liver metastases with unusual morphology must be borne in mind for patients with a history of carcinoma in the digestive tract.
Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan.
Atsushi
A
Nanashima
Syuuichi
S
Tobinaga
Masato
M
Araki
Masaki
M
Kunizaki
Kuniko
K
Abe
Hideyuki
H
Hayashi
Kenichi
K
Harada
Yasuni
Y
Nakanuma
Tohru
T
Nakagoe
Hiroaki
H
Takeshita
Terumitsu
T
Sawai
Takeshi
T
Nagayasu
D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D003110:Colonic Neoplasms / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000556:secondary*; D008297:Male
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