Ushida Yuta, Sugawara Gen, Minami Takayuki, Yamashita Yoriko, Inoue Masaya
Department of Surgery, Toyota Kosei Hospital, Toyota, Aichi, Japan.
Department of Pathology, Toyota Kosei Hospital, Toyota, Aichi, Japan.
Surg Case Rep. 2025;11(1). doi: 10.70352/scrj.cr.25-0086. Epub 2025 May 1.
Cholangiolocarcinoma (CLC) with ductal plate malformation (DPM) is a rare primary liver cancer originating from the canals of Hering. It often exhibits intermediate behavior between hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Diagnosing CLC with DPM is challenging due to overlapping imaging features with other liver malignancies.
An 82-year-old man under surveillance for bladder cancer was incidentally found to have a liver nodule in segment 8. Over 6 years, the lesion grew from 10 mm to 41 mm and showed dynamic changes on imaging. Despite two inconclusive biopsies, a diagnosis of CLC with DPM was confirmed after a third biopsy and consultation with a specialized institution. The patient underwent a right hepatectomy, and pathological examination confirmed CLC with DPM. No evidence of recurrence was observed 19 months post-surgery.
This case underscores the importance of long-term follow-up and a multidisciplinary approach in managing rare hepatic malignancies. The clinical course provides valuable insights into the progression of CLC with DPM and may aid in diagnosing similar challenging cases.
伴有胆管板畸形(DPM)的胆管细胞癌(CLC)是一种起源于赫林管的罕见原发性肝癌。它通常表现出肝细胞癌和肝内胆管癌之间的中间行为。由于与其他肝脏恶性肿瘤的影像学特征重叠,诊断伴有DPM的CLC具有挑战性。
一名接受膀胱癌监测的82岁男性偶然发现肝8段有一个肝结节。在6年多的时间里,病变从10毫米长到41毫米,并在影像学上显示出动态变化。尽管两次活检结果不明确,但在第三次活检并咨询专业机构后,确诊为伴有DPM的CLC。患者接受了右肝切除术,病理检查证实为伴有DPM的CLC。术后19个月未观察到复发迹象。
该病例强调了在管理罕见肝脏恶性肿瘤时长期随访和多学科方法的重要性。该临床过程为伴有DPM的CLC的进展提供了有价值的见解,并可能有助于诊断类似的具有挑战性的病例。