title: Unusual images of mass-forming intrahepatic cholangiocarcinoma.
abstract: We experienced a case of mass-forming intrahepatic cholangiocarcinoma which could not been diagnosed accurately without pathologic findings. A 78-year-old Japanese woman with no particular symptoms was admitted for changes in liver function tests. Ultrasonography revealed a solid liver tumor. When there are no typical imaging features, no pathognomonic clinical findings and no obvious risk factors for any specific hepatic tumor, it may be difficult to make an accurate diagnosis before surgical resection. The lesion was resected on the basis of a high degree of suspicion for malignancy and submitted for pathologic evaluation. Microscopically, the neoplasm was a moderately differentiated adenocarcinoma with abundant fibrous stroma, consistent with a mass-forming cholangiocarcinoma. This case exemplifies the importance of considering the various tumorous and non-tumorous diseases in the differential diagnosis of a liver mass with atypical features, especially when malignancy cannot be excluded.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokyo, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Takakura
authors.forename: Mikio
authors.initials: M
authors.lastname: Kajihara
authors.forename: Tetsuyoshi
authors.initials: T
authors.lastname: Iwasaki
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ide
authors.forename: Tamihiro
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Arai
authors.forename: Masayuki
authors.initials: M
authors.lastname: Saruta
authors.forename: Seiji
authors.initials: S
authors.lastname: Arihiro
authors.forename: Mika
authors.initials: M
authors.lastname: Matsuoka
authors.forename: Shigeo
authors.initials: S
authors.lastname: Koido
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Ito
authors.forename: Michinori
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Gocho
authors.forename: Shigeki
authors.initials: S
authors.lastname: Wakiyama
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
authors.forename: Hisao
authors.initials: H
authors.lastname: Tajiri
keywords: Mass-forming intrahepatic cholangiocarcinoma; Moderately differentiated adenocarcinoma