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Laparoscopic left hepatectomy for a patient with intrahepatic cholangiocarcinoma metastasis in the falciform ligament: a case report.
Nomura, Yoriko; Sakai, Hisamune; Akiba, Jun; Hisaka, Toru; Sato, Toshihiro; Goto, Yuichi; Akashi, Masanori; Fukutomi, Shogo; Muroya, Daisuke; Kanno, Hiroki; Okamura, Shusuke; Yano, Yuta; Yano, Hirohisa; Akagi, Yoshito; Okuda, Koji.
Afiliación
  • Nomura Y; Department of Surgery, Kurume University Hospital, Kurume, Japan.
  • Sakai H; Department of Surgery, Kurume University Hospital, Kurume, Japan. hisamune@med.kurume-u.ac.jp.
  • Akiba J; Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Fukuoka, Japan.
  • Hisaka T; Department of Surgery, Kurume University Hospital, Kurume, Japan.
  • Sato T; Department of Surgery, Kurume University Hospital, Kurume, Japan.
  • Goto Y; Department of Surgery, Kurume University Hospital, Kurume, Japan.
  • Akashi M; Department of Surgery, Kurume University Hospital, Kurume, Japan.
  • Fukutomi S; Department of Surgery, Kurume University Hospital, Kurume, Japan.
  • Muroya D; Department of Surgery, Kurume University Hospital, Kurume, Japan.
  • Kanno H; Department of Surgery, Kurume University Hospital, Kurume, Japan.
  • Okamura S; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
  • Yano Y; Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
  • Yano H; Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
  • Akagi Y; Department of Surgery, Kurume University Hospital, Kurume, Japan.
  • Okuda K; Department of Surgery, Kurume University Hospital, Kurume, Japan.
BMC Surg ; 21(1): 122, 2021 Mar 08.
Article en En | MEDLINE | ID: mdl-33685435
ABSTRACT

BACKGROUND:

Intrahepatic cholangiocarcinoma (ICC) is primary cancer of the liver with poor prognosis because of its high potential for recurrence and metastasis. We experienced a rare case of ICC with hematogenous metastasis to the falciform ligament. We aimed to clarify the route of metastasis to the mesentery by increasing the accuracy of preoperative imaging and establish a hepatectomy to control cancer. CASE PRESENTATION An 85-year-old woman was referred to our hospital for a detailed study of progressively increasing liver tumors. She had no subjective symptoms. Her medical history showed hypertension, aneurysm clipping for cerebral hemorrhage, and gallstones. A detailed physical examination and laboratory data evaluation included tumor markers but did not demonstrate any abnormalities. On computed tomography scan, contrast-enhanced ultrasound, and magnetic resonance imaging with gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid, the tumor appeared to be located in liver segment IV, protruding outside the liver. It appeared to contain two distinct components; we suspected ICC in the intrahepatic tumor component. Laparoscopic observation revealed that the extrahepatic lesion was an intra-falciform ligament mass; laparoscopic left hepatectomy was performed. Microscopically, the main tumor in segment IV was 15 mm in diameter and was diagnosed as moderately and poorly differentiated ICC. The tumor of the intra-falciform ligament was not continuous with the main intrahepatic nodule and was also diagnosed as ICC with extensive necrosis. There were no infiltrates in the round ligament of the liver, and several tumor thrombi were found in the small veins of the falciform ligament.

CONCLUSIONS:

To date, there have been a few reports of metastases of primary liver cancer to the falciform ligament. At the time of preoperative imaging and pathological diagnosis, this case was suggestive of considering that the malignant liver tumor might be suspected of metastasizing to the falciform ligament. Our case improves awareness of this pathology, which can be useful in the future when encountered by hepatic specialists and surgeons.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Colangiocarcinoma / Ligamentos / Neoplasias Hepáticas Tipo de estudio: Prognostic_studies Límite: Aged80 / Female / Humans Idioma: En Revista: BMC Surg Año: 2021 Tipo del documento: Article País de afiliación: Japón

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Colangiocarcinoma / Ligamentos / Neoplasias Hepáticas Tipo de estudio: Prognostic_studies Límite: Aged80 / Female / Humans Idioma: En Revista: BMC Surg Año: 2021 Tipo del documento: Article País de afiliación: Japón