title: A case of concomitant colitic cancer and intrahepatic cholangiocarcinoma during follow-up for ulcerative colitis.
abstract: Colitis-associated colorectal cancer (CAC) is known to occur in long-standing and extensive ulcerative colitis (UC). Furthermore, UC is known to complicate primary sclerosing cholangitis (PSC), which subsequently results in an increased risk of developing cholangiocarcinoma. We report a case of colitis-associated rectal cancer (CARC) accompanied by intrahepatic cholangiocarcinoma (ICC) based on UC and PSC. A 73-year-old man had suffered from UC for 19 years. During surveillance colonoscopy, a tumor was found in the rectum that was pathologically diagnosed as CARC from the resected specimen. Abdominal computed tomography also revealed a localized dilation of the intrahepatic bile duct, and endoscopic retrograde cholangiography revealed a band-like stricture. This remarkable tumor lesion was not observed in the hepatic duct. Left hepatectomy was performed because of the suspicion of possible ICC at the stenosis of the hepatic duct. The presence of ICC was confirmed at the lesion causing the stricture. The pathological diagnosis from the resected specimen was ICC based on PSC. Adjuvant chemotherapy for ICC was performed for 6 months. Neither cancer has recurred for 2.5 years after hepatectomy. Patients with PSC concomitant with UC should be considered a high-risk group for CAC and ICC.
authors.affiliation: Division of Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, Miyazaki, Japan.
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Tsuchiya
authors.affiliation: Division of Hepato-Biliary-Pancreas Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan. a_nanashima@med.miyazaki-u.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.affiliation: Division of Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, Miyazaki, Japan.
authors.forename: Takuto
authors.initials: T
authors.lastname: Ikeda
authors.affiliation: Ikime Coloproctological Clinic, Miyazaki, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Minami
authors.affiliation: Miyazaki Medical Center Hospital, Miyazaki, Japan.
authors.forename: Motoaki
authors.initials: M
authors.lastname: Nagano
authors.affiliation: Division of Hepato-Biliary-Pancreas Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
authors.forename: Takeomi
authors.initials: T
authors.lastname: Hamada
authors.affiliation: Division of Hepato-Biliary-Pancreas Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Yano
authors.affiliation: Division of Hepato-Biliary-Pancreas Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Fujii
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D015209:Cholangitis, Sclerosing / Q000150:complications; D003093:Colitis, Ulcerative / Q000150:complications*; D003113:Colonoscopy; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Cholangiocarcinoma; Colitic cancer; PSC; UC