title: Unrecognized intrahepatic cholangiocarcinoma: an analysis of 993 adult cirrhotic liver explants.
abstract: Liver cirrhosis is a recognized risk factor for intrahepatic cholangiocarcinoma (I-CCa). Small I-CCa nodules might be undiagnosed or misdiagnosed as hepatocellular carcinoma (HCC) in the context of liver cirrhosis. The aim of this study was to determine the prevalence and clinical impact of undetected I-CCa in liver explants of adult cirrhotic patients undergoing liver transplantation (LT). From December 1985 to November 2008, a first LT was performed in 993 adult cirrhotic patients in three French academic Hospitals. All liver explants were analyzed for the presence of nodules. The diagnosis of HCC was made in 331 cases (33.3% of the patients). Similarly, an I-CCa was identified in 10 (1%) patients, with a mean size of 31 ± 17 mm. The mean age at transplantation was 58.8 yr (range 45 - 66), and all the patients were men. The mean follow-up after LT was 33 months (range 4-52). Post-transplant tumor recurrence was observed in five patients (50%), after a mean delay of 10 months. All five patients died. Malignant recurrence was associated with the presence of venous emboli on liver explants. Our results suggest that unrecognized I-CCa complicating liver cirrhosis is a rare entity, associated with high risk of recurrence and poor prognosis.
authors: Hospices Civils de Lyon, Hôpital E. Herriot, Fédération des Spécialités Digestives, Lyon, France.
authors: Mélanie
authors: M
authors: Vallin
authors: Nathalie
authors: N
authors: Sturm
authors: Géraldine
authors: G
authors: Lamblin
authors: Olivier
authors: O
authors: Guillaud
authors: Marie-Noëlle
authors: MN
authors: Hilleret
authors: Valérie
authors: V
authors: Hervieu
authors: Juliette
authors: J
authors: Joubert
authors: Armand
authors: A
authors: Abergel
authors: Vincent
authors: V
authors: Leroy
authors: Olivier
authors: O
authors: Boillot
authors: Jérôme
authors: J
authors: Dumortier
authors: Jean-Yves
authors: JY
authors: Scoazec
mesh_terms: D000328:Adult; D001650:Bile Duct Neoplasms; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000401:mortality / Q000601:surgery; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate