title: Solitary rib recurrence of hilar cholangiocarcinoma 10 years after resection: report of a case.
abstract: A 61-year-old female underwent right hemihepatectomy and caudate lobectomy for hilar cholangiocarcinoma in 1999. Ten years later, increasing serum carbohydrate 19-9 was detected by routine follow-up. Subsequent positron emission tomography revealed an asymptomatic lesion in the right 11th rib. As the mass steadily grew in size, the lesion was resected en bloc with the affected rib and muscle. The histopathological findings closely resembled those of the primary cholangiocarcinoma. Thus, the tumor was diagnosed as a metastatic recurrence 10 years after resection of the primary tumor. There have been a few reports of cholangiocarcinoma recurrence in long-term survivors at the surgical margins, peritoneum, or transhepatic drainage route. However, there are no reports of solitary extra-abdominal recurrence. This case highlights the need for careful follow-up of patients with cholangiocarcinoma and nodal metastasis, even in the absence of recurrence for >5 years after curative resection.
authors: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan.
authors: Yohei
authors: Y
authors: Ota
authors: Ryusei
authors: R
authors: Matsuyama
authors: Koichi
authors: K
authors: Taniguchi
authors: Michio
authors: M
authors: Ueda
authors: Kazuhisa
authors: K
authors: Takeda
authors: Kuniya
authors: K
authors: Tanaka
authors: Takashi
authors: T
authors: Nakayama
authors: Itaru
authors: I
authors: Endo
keywords: Carbohydrate antigen 19-9; Cholangiocarcinoma; Long-term survivor; Positron emission tomography; Rib recurrence