Tasch Joseph J, Dube Nirva
Graduate Medical Education, Camden Clark Medical Center, Parkersburg, WV, USA.
Department of Internal Medicine, Camden Clark Medical Center, Parkersburg, WV, USA.
Am J Case Rep. 2018 Jan 10;19:35-40. doi: 10.12659/ajcr.906165.
BACKGROUND Intrahepatic cholangiocarcinoma is a rare condition which typically occurs in males between 50 and 70 years of age, and presents with symptoms related to biliary obstruction including jaundice, pruritus, and dark urine. Other common symptoms at presentation include abdominal pain, weight loss, and fever. CASE REPORT We present a case of a 67-year-old female initially presenting with chest pain at rest, found to have a lung nodule on diagnostic imaging at the time of admission. On further imaging, a 9 cm liver lesion was incidentally discovered, initially suspicious for hepatocellular carcinoma on imaging, with initial biopsy staining CK7 positive, and CK20 negative. The patient also had an elevated alpha-fetoprotein level. Biopsy results were later confirmed as moderately differentiated adenocarcinoma consistent with intrahepatic cholangiocarcinoma. CONCLUSIONS This report illustrates an unusual presentation of intrahepatic cholangiocarcinoma. Although rare, cholangiocarcinoma is diagnosed most frequently as an incidental finding on imaging studies. With quick work-up and successful biopsy results, patients can undergo surgical or chemo-radiation therapy earlier, potentially leading to a longer survival time.
肝内胆管癌是一种罕见疾病，通常发生于50至70岁男性，表现为与胆道梗阻相关的症状，包括黄疸、瘙痒和深色尿液。其他常见的就诊症状包括腹痛、体重减轻和发热。病例报告：我们报告一例67岁女性病例，最初表现为静息时胸痛，入院时诊断性影像学检查发现肺部结节。进一步影像学检查时，偶然发现一个9厘米的肝脏病变，最初影像学检查怀疑为肝细胞癌，初次活检染色CK7阳性，CK20阴性。患者甲胎蛋白水平也升高。活检结果后来确认为中度分化腺癌，符合肝内胆管癌。结论：本报告说明了肝内胆管癌的一种不寻常表现。胆管癌虽然罕见，但最常作为影像学检查的偶然发现被诊断出来。通过快速检查和成功的活检结果，患者可以更早地接受手术或放化疗，有可能延长生存时间。
