Akabane Shintaro, Ohira Masahiro, Kobayashi Tsuyoshi, Kuroda Shintaro, Tanimine Naoki, Shimizu Seiichi, Tahara Hiroyuki, Ide Kentaro, Ishiyama Kohei, Egi Hiroyuki, Tanabe Kazuaki, Sentani Kazuhiro, Yasui Wataru, Ohdan Hideki
Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Department of Molecular Pathology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
Surg Case Rep. 2016 Dec;2(1):94. doi: 10.1186/s40792-016-0222-x. Epub 2016 Sep 9.
We experience many cases of liver metastasis from colorectal cancer, but synchronous occurrence of intrahepatic cholangiocarcinoma (ICC) and liver metastasis from a rectal cancer is extremely rare. We herein report a case of ICC coinciding with a liver metastasis from a known rectal carcinoma.
A 68-year-old man was referred to our hospital for investigation of multiple liver tumors. Total colonoscopy and computed tomography (CT) revealed a rectal carcinoma, coinciding with liver metastasis. He was planned to receive chemotherapy following rectal resection. During chemotherapy for the rectal cancer, one of the liver tumors gradually grew after first shrinking. The following hepatectomy revealed the presence of intrahepatic cholangiocarcinoma (ICC). Despite intensive chemotherapy for the ICC, he passed away 6 months after the hepatectomy.
We should also suspect the possibility of multiple primary cancers, even if the patient has a history of cancer that is likely to cause metastatic lesions. When simultaneous neoplasms are diagnosed, systematic treatment should be targeted to the tumor with the worst prognosis.
我们遇到过许多结直肠癌肝转移的病例，但肝内胆管癌（ICC）与直肠癌肝转移同时发生的情况极为罕见。我们在此报告一例ICC与已知直肠癌肝转移同时存在的病例。
一名68岁男性因多发性肝肿瘤被转诊至我院。全结肠镜检查和计算机断层扫描（CT）显示为直肠癌，同时伴有肝转移。计划在直肠切除术后进行化疗。在直肠癌化疗期间，其中一个肝肿瘤在首次缩小后逐渐增大。随后的肝切除术显示存在肝内胆管癌（ICC）。尽管对ICC进行了强化化疗，但他在肝切除术后6个月去世。
即使患者有可能导致转移灶的癌症病史，我们也应怀疑多原发性癌症的可能性。当同时诊断出肿瘤时，系统治疗应针对预后最差的肿瘤。
