Sarcomatoid intrahepatic cholangiocarcinoma mimicking liver abscess: A case report  

作　　者：Yan Wang Jia-Lei Ming Xing-Yu Ren Lu Qiu Li-Juan Zhou Shu-Dong Yang Xiang-Ming Fang 

机构地区：[1]Department of Radiology,The Affiliated Wuxi People’s Hospital of Nanjing Medical University,Wuxi 214023,Jiangsu Province,China [2]Department of Pathology,The Affiliated Wuxi People’s Hospital of Nanjing Medical University,Wuxi 214023,Jiangsu Province,China

出　　处：《World Journal of Clinical Cases》2020年第1期208-216,共9页世界临床病例杂志

基　　金：Supported by National Natural Science Foundation of China,No.81271629;Medical Innovation Team of Wuxi City,No.CXTD002

摘　　要：BACKGROUND Sarcomatoid intrahepatic cholangiocarcinoma(SICC) is an extremely rare and highly invasive malignant tumor of the liver. To our knowledge, the imaging findings of sarcomatous cholangiocarcinoma have been rarely reported; and radiological features of this tumor mimicking liver abscess have not yet been reported.CASE SUMMARY We present a case of SICC mimicking liver abscess. The patient, a 43-year-old male, complained of repeated upper right abdominal discomfort and intermittent distension over a period of one month. Radiology examination revealed a huge focal lesion in the right liver. The lesion was hypointense on computed tomography with honeycomb enhancement surrounded by enhanced peripheral areas. It showed a hypo-signal on non-contrast T1-weighted images and a hypersignal on non-contrast T2-weighted images. Radiologists diagnosed the lesion as an atypical liver abscess. The patient underwent a hepatectomy. After surgery, he survived another 2.5 mo before passing away. A search of Pub Med and Google revealed 43 non-repeated cases of SICC reported in 20 published studies. The following is a short review in order to improve the diagnostic and therapeutic skills in cases of SICC.CONCLUSION This report presents the clinical and radiological features of SICC and imaging features which showed hypovascularity and progressive enhancement. SICC can present as a multilocular cyst on radiological images and it is necessary to distinguish this lesion from an atypical abscess. Simple surgical treatment is not the best treatment option for this disease.Sarcomatoid intrahepatic cholangiocarcinoma(SICC)is an extremely rare and highly invasive malignant tumor of the liver.To our knowledge,the imaging findings of sarcomatous cholangiocarcinoma have been rarely reported;and radiological features of this tumor mimicking liver abscess have not yet been reported.CASE SUMMARY We present a case of SICC mimicking liver abscess.The patient,a 43-year-old male,complained of repeated upper right abdominal discomfort and intermittent distension over a period of one month.Radiology examination revealed a huge focal lesion in the right liver.The lesion was hypointense on computed tomography with honeycomb enhancement surrounded by enhanced peripheral areas.It showed a hypo-signal on non-contrast T1-weighted images and a hypersignal on non-contrast T2-weighted images.Radiologists diagnosed the lesion as an atypical liver abscess.The patient underwent a hepatectomy.After surgery,he survived another 2.5 mo before passing away.A search of PubMed and Google revealed 43 non-repeated cases of SICC reported in 20 published studies.The following is a short review in order to improve the diagnostic and therapeutic skills in cases of SICC.CONCLUSION This report presents the clinical and radiological features of SICC and imaging features which showed hypovascularity and progressive enhancement.SICC can present as a multilocular cyst on radiological images and it is necessary to distinguish this lesion from an atypical abscess.Simple surgical treatment is not the best treatment option for this disease.

关 键 词：Sarcomatoid intrahepatic cholangiocarcinoma Liver abscess Radiological features Case report 

分 类 号：R73[医药卫生—肿瘤]