Intrahepatic cholangiocarcinoma with clear cell type following laparoscopic curative surgery.

Takuya Yamamoto,Toshio Noriyuki,Nozomu Matsumoto,Yoshio Katamura,Hideki Ohdan,Akihiko Oshita,Shuji Yonehara,Masahiro Nakahara,Tsuyoshi Kobayashi,Tomoyuki Abe

doi:10.1186/s40792-020-01041-2

Takuya Yamamoto, Toshio Noriyuki + Show 8 more

Open Access

https://doi.org/10.1186/s40792-020-01041-2

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Abstract

BackgroundIntrahepatic cholangiocarcinoma (ICC) is the second most common malignancy of primary liver cancer. Among the several pathological types of ICC, only five cases of the clear cell type have been reported, including the one presented below. Here we report a unique case of clear cell type ICC following laparoscopic hepatectomy.Case presentationA 67-year-old woman had a history of hepatitis B virus. Computed tomography revealed a ring-like enhanced mass 35 mm in diameter at segment 7 in the early phase. The enhancement was prolonged to the late phase through the portal phase, while the shape was irregular. Ethoxybenzy magnetic resonance imaging revealed that the tumor had a low signal intensity on T1-weighted imaging and a high signal intensity on T2-weighted imaging. Diffusion-weighted images identified that the tumor had remarkably high signal intensity. Tumor enhancement was not detected throughout the tumor in the hepatocyte phase. Upon ICC diagnosis, a laparoscopic S7 subsegmentectomy was performed. The patient’s postoperative course was uneventful. An immunohistochemical examination revealed that the cells tested positive for cytokeratin 7 (CK7), CK19, and CD56 and negative for CK20, CD10, α-fetoprotein, thyroid transcription factor-1. At 2 years after surgery, the patient remains alive without recurrence.ConclusionsHere we presented a case of clear cell ICC that was treated by laparoscopic hepatectomy. Immunological analysis, especially by CD56 and several CK markers, is helpful for diagnosing this disease.

Highlights

Intrahepatic cholangiocarcinoma (ICC) is the second most common malignancy of primary liver cancer
Here we presented a case of clear cell ICC that was treated by laparoscopic hepatectomy
Histopathologically, ICC develops as various tissues form, such as well-differentiated adenocarcinoma, adenosquamous carcinoma, mucinous carcinoma, mucoepidermoid carcinoma, squamous carcinoma, sarcomatoid carcinoma, and signet-ring cell carcinoma [4, 6]

Summary

Conclusions

ICC develops as various tissues form, such as well-differentiated adenocarcinoma, adenosquamous carcinoma, mucinous carcinoma, mucoepidermoid carcinoma, squamous carcinoma, sarcomatoid carcinoma, and signet-ring cell carcinoma [4, 6]. Some cancers show a clear cell type, such as ICC, HCC, gallbladder carcinoma, and metastasis of lung or thyroid cancer [4, 6,7,8]. Three patients survived without recurrence after receiving curative surgery Based on this observation, clear cell ICC might have a better prognosis than ordinary ICC. To the best of our knowledge, this is the first report of a clear cell ICC case undergoing laparoscopic hepatectomy. Ban et al proposed that degree of difficulty of laparoscopic hepatectomy is related to the maximal tumor diameter, tumor location, and liver function. Here we presented a case of clear cell ICC following laparoscopic hepatectomy.

Background