Metastasis of hepatocellular carcinoma occurs at a relatively late stage of the disease. Hematogenous and lymphatic metastases are the most common routes for dissemination of tumor cells. Hepatocellular carcinoma also extends into the adjacent portal vein and bile ducts. Since there is no peritoneum between the body of the gallbladder and the liver fossa, gallbladder cancer can easily cross the boundary. Gallbladder invasion of hepatocellular carcinoma, however, is quite rare. We report a case of hepatocellular- cholangiocarcinoma in a non-cirrhotic liver that invaded the gallbladder mimicking the gallbladder carcinoma complicated by cholecystitis and liver abscess.
Aged ; Bile Duct Neoplasms/*pathology ; *Bile Ducts, Intrahepatic ; Carcinoma, Hepatocellular/pathology/*secondary ; Cholangiocarcinoma/pathology/*secondary ; English Abstract ; Female ; Gallbladder Neoplasms/diagnosis/*secondary ; Humans ; Liver Neoplasms/*pathology ; Neoplasm Invasiveness

OBJECTIVETo explore the diagnosis and treatment of the cholangiocarcinoma.

METHODSForty one patients with cholangiocarcinoma who were enrolled in our hospital from January 1970 to January 2005 were retrospectively analyzed.

RESULTSAmong these 41 patients, the 1, 3, and 5-year survival rate was 82.3%, 45.8%, 45.8%, respectively, with radical operation, and was 11.0%, 0, 0 with non-radical operation (chi2 = 21.38, P < 0.01). The 1-year and 3-year survival rate was 11.0% and 0 in 9 patients treated with laparatomy, which was not significantly different from those treated with non-radical operation (chi2 = 0.02, P = 0.89). Four patients did not receive operation and all died within one year. Among 25 patients who did not experience lymph node metastasis, the 1, 3, and 5-year survival rate was 58.4%, 27.3%, and 27.3%. Among 16 patients who were found lymph node metastasis, the 1-year and 3-year survival rate was 61.8% and 0 (chi2 = 13.85, P < 0.01).

CONCLUSIONOperation is the most effective treatment for cholangiocarcinoma. Radical operation is the only curative treatment.

Bile Duct Neoplasms ; diagnosis ; pathology ; therapy ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; diagnosis ; secondary ; therapy ; Female ; Humans ; Lymphatic Metastasis ; Male

Cutaneous metastases rarely develop in patients with internal malignancy. Cholangiocarcinoma, a malignant cancer of the bile duct, is a relatively rare adenocarcinoma and has a poor prognosis. Few reports have mentioned cutaneous metastases of cholangiocarcinoma, and the most of them were due to direct tumor seeding by percutaneous procedures. Herein, we report a case of cholangiocarcinoma with distant cutaneous metastases in a 60-year-old man.
Bile Duct Neoplasms/*diagnosis/pathology ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*diagnosis/pathology/secondary ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Male ; Middle Aged ; Positron-Emission Tomography ; Skin Neoplasms/*diagnosis/pathology/secondary ; Tomography, X-Ray Computed

Intrahepatic cholangiocarcinoma is a rare malignancy that originates from the epithelial cells of the intrahepatic bile ducts. Intrahepatic cholangiocarcinoma can metastasize in lymphatic chains, including the hepatoduodenal ligament, and it often invades adjacent organs or metastasizes to other visceral organs such as the lungs, bones, adrenal glands, and brain. However, distant skeletal muscle metastasis is very rare. Moreover, a metastatic skeletal muscle tumor rarely shows specific symptoms, making it difficult to identify in a routine examination. A 45-year-old man with a chief complaint of right upper quadrant abdominal pain was admitted to our hospital. Abdominal ultrasound and computed tomography with contrast enhancement showed a malignant mass in the right hepatic lobe, and 2-[18F] fluoro-2-deoxy-D-glucose positron-emission tomography revealed distant skeletal muscle metastases in the thorax and buttock. The patient underwent an ultrasound-guided percutaneous needle biopsy for the metastatic low-echo masses in the skeletal muscle.
Bile Duct Neoplasms/diagnosis/radionuclide imaging/secondary ; Cholangiocarcinoma/diagnosis/radionuclide imaging/secondary ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Liver Neoplasms/*diagnosis/pathology/radionuclide ; Male ; Middle Aged ; Muscle Neoplasms/diagnosis/*radionuclide imaging/secondary ; Positron-Emission Tomography ; Radiopharmaceuticals/*diagnostic use ; Tomography, X-Ray Computed

OBJECTIVETo explore the diagnostic significance of glypican-3 (GPC3) immunohistochemistry in hepatocellular carcinoma (HCC).

METHODSFourteen tissue microarray paraffin blocks were constructed, which comprised 731 samples from hepatic tumors and paratumor tissues, including 357 cases of HCC, 26 cholangiocarcinoma, 171 HCC adjacent hepatic tissue including cirrhosis, 93 hemangioma adjacent hepatic tissues, and 84 carcinomas metastatic to liver. GPC3 (Clone 1G12) protein was detected immunohistochemically in all of cases with positive controls.

RESULTSGPC3 protein was positive in 72.0% HCC (257/357), but negative in the rest 374 of non-HCC cases, including cholangiocarcinoma, HCC adjacent hepatic tissue including cirrhosis, hemangioma adjacent hepatic tissues and metastatic carcinomas. GPC3 positive percentage was significantly correlated with histological grading of HCC (P < 0.01), highest in grade 3 (77.1%, 64/83) followed by grade 2 (73.3%, 187/255), grade 1 (6/12) and grade 4 (0).

CONCLUSIONSGPC3 is a valuable diagnostic marker for hepatocellular carcinoma with sensitivity of 72.0%, and a differential diagnostic marker from tumor adjacent hepatic tissue and carcinomas metastatic to liver with specificity of 100%.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; metabolism ; Carcinoma, Hepatocellular ; diagnosis ; metabolism ; pathology ; Child ; Child, Preschool ; Cholangiocarcinoma ; diagnosis ; metabolism ; Colonic Neoplasms ; diagnosis ; metabolism ; Diagnosis, Differential ; Female ; Glypicans ; metabolism ; Hemangioma ; diagnosis ; metabolism ; Humans ; Immunohistochemistry ; Liver ; metabolism ; pathology ; Liver Cirrhosis ; diagnosis ; metabolism ; Liver Neoplasms ; diagnosis ; metabolism ; pathology ; secondary ; Male ; Middle Aged ; Neoplasm Grading ; Young Adult