title: Primary or metastatic hepatic carcinoma? A breast cancer patient after adjuvant chemotherapy and radiotherapy postoperatively with intrahepatic cholangiocarcinoma and review of the literature.
abstract: BACKGROUND
  The liver is a common site of metastases, followed by the bone and lung in breast cancer. The symptoms of hepatic metastases are similar to intrahepatic cholangiocarcinoma (ICC). ICC is rare, with an overall incidence rate of 0.95 cases per 100,000 adults. The incidence of ICC for patients with breast cancer is very uncommon. Breast cancer patient with ICC is easily misdiagnosed as hepatic metastases.
  
  
  METHODS
  We report a breast cancer patient postoperatively who was hospitalized because of having continuous irregular fever for 1 month. Antibiotics were given for 1 week without any significant effect. Her admission bloods revealed elevated levels of carcino-embryonic antigen. Magnetic resonance imaging diagnosis showed multiple liver metastases. We believed that the woman had hepatic metastases until biopsy guided by computed tomography. The liver biopsy pathology analysis considered the possibility of primary intrahepatic cholangiocarcinoma.
  
  
  CONCLUSIONS
  Breast cancer patient with space-occupying lesions in the liver is easily considered to be progressed hepatic metastases. Image-guided biopsy is the best diagnostic method for breast cancer with liver mass to avoid misdiagnosis and classify the molecular subtypes to make appropriate treatment.
authors.affiliation: School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China.|Department of Oncology, Shandong Academy of Medical Sciences, Shandong Cancer Hospital affiliated to Shandong University, 440 Ji-Yan Road, Jinan, 250117, Shandong Province, People's Republic of China.
authors.forename: Zhao-Yun
authors.initials: ZY
authors.lastname: Liu
authors.affiliation: Department of Oncology, Shandong Academy of Medical Sciences, Shandong Cancer Hospital affiliated to Shandong University, 440 Ji-Yan Road, Jinan, 250117, Shandong Province, People's Republic of China.
authors.forename: Ju-Jie
authors.initials: JJ
authors.lastname: Sun
authors.affiliation: School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China.|Department of Oncology, Shandong Academy of Medical Sciences, Shandong Cancer Hospital affiliated to Shandong University, 440 Ji-Yan Road, Jinan, 250117, Shandong Province, People's Republic of China.
authors.forename: Ke-Wen
authors.initials: KW
authors.lastname: He
authors.affiliation: Department of Oncology, Shandong Academy of Medical Sciences, Shandong Cancer Hospital affiliated to Shandong University, 440 Ji-Yan Road, Jinan, 250117, Shandong Province, People's Republic of China.
authors.forename: Pei-Ying
authors.initials: PY
authors.lastname: Zhuo
authors.affiliation: Department of Oncology, Shandong Academy of Medical Sciences, Shandong Cancer Hospital affiliated to Shandong University, 440 Ji-Yan Road, Jinan, 250117, Shandong Province, People's Republic of China. drzhiyongyu@aliyun.com.
authors.forename: Zhi-Yong
authors.initials: ZY
authors.lastname: Yu
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000150:complications* / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003951:Diagnostic Errors / Q000517:prevention & control*; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D061705:Image-Guided Biopsy; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008408:Mastectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents
keywords: Breast neoplasm; Intrahepatic cholangiocarcinoma; Liver metastases