Adrenal cholangiocarcinoma: a case report and literature review

Abstract

Objective To discuss the clinical characteristics and pathologic features of adrenal cholangiocarcinoma. Methods We reported one extremely rare adrenal cholangiocarcinoma case and review the relative literature. A 71-year-old male was admitted with right adrenal mass for 2 months. Patient has been suffered from hypertension and controlled by oral drugs for ten years. Enhanced computerized tomography (CT) revealed a mass in right adrenal gland area, with the size of 7.1 cm×6.8 cm×4.4 cm and inhomogeneous enhancement in arterial phase. Adrenal functional examination showed no obvious abnormalities of serum catecholamine, supine RAAS, cortisol determination and rhythm and urine VMA detection. Results After medical preparation of phenoxybenzamine for 3 weeks preoperatively, the patient's blood pressure was maintained at 110-125/80-90 mmHg and with stuffy nose and ruddy nail bed. The patient′s weight gained of 1kg than before. Retroperitoneal laparoscopic resection of right adrenal tumor was performed in general anesthesia. The tumor that related to the inferior vena cava and liver was successfully removed without any other damage. The operation time was 155 min and estimated blood volume was 50 ml. Perioperative blood pressure of patient was stable and recovery was well. According to clinical characteristic and pathological test and immunohistochemical results, patient was diagnosed with adrenal cholangiocarcinoma. Followed up for 15 months, no tumor recurrence and metastasis based on ultrasound examination and CT, and with normal blood pressure. Conclusions Adrenal cholangiocarcinoma was extremely rare type in the adrenal malignant tumors based on hepato-adrenal fusion histologically. This case constitutes a contribution for the knowledge of adrenal cholangiocarcinoma. The imaging findings were heterogeneous enhancement of soft tissue masses, and there was no obvious abnormality in adrenal functional examination. The retroperitoneal laparoscopic surgery is a treatment choice for this kind of patient. Key words: Adrenal gland neoplasm; Cholangiocarcinoma; Adrenalectomy