Isolated brain metastases prior to locoregional recurrence in hilar cholangiocarcinoma.

Isolated brain metastases prior to locoregional recurrence from hilar cholangiocarcinoma (HCCA) following curative resection are an extremely rare event. Very few reports regarding brain metastasis prior to locoregional recurrence following curative resection have been published due to the fact that to differentiate brain metastases from HCCA recurrence is challenging, particular in the early stages, since the neurological findings of brain metastasis are occult and subtle. Any patient with HCCA who has undergone radical resection and subsequently presented with a further onset of neurological symptoms should be evaluated for brain involvement. The present case study describes a patient with HCCA who underwent curative resection, and experienced isolated brain metastases prior to locoregional recurrence.