Sarcomatoid intrahepatic cholangiocarcinoma(SICC)is an extremely rare and highly invasive malignant tumor of the liver.To our knowledge,the imaging findings of sarcomatous cholangiocarcinoma have been rarely reported;...Sarcomatoid intrahepatic cholangiocarcinoma(SICC)is an extremely rare and highly invasive malignant tumor of the liver.To our knowledge,the imaging findings of sarcomatous cholangiocarcinoma have been rarely reported;and radiological features of this tumor mimicking liver abscess have not yet been reported.CASE SUMMARY We present a case of SICC mimicking liver abscess.The patient,a 43-year-old male,complained of repeated upper right abdominal discomfort and intermittent distension over a period of one month.Radiology examination revealed a huge focal lesion in the right liver.The lesion was hypointense on computed tomography with honeycomb enhancement surrounded by enhanced peripheral areas.It showed a hypo-signal on non-contrast T1-weighted images and a hypersignal on non-contrast T2-weighted images.Radiologists diagnosed the lesion as an atypical liver abscess.The patient underwent a hepatectomy.After surgery,he survived another 2.5 mo before passing away.A search of PubMed and Google revealed 43 non-repeated cases of SICC reported in 20 published studies.The following is a short review in order to improve the diagnostic and therapeutic skills in cases of SICC.CONCLUSION This report presents the clinical and radiological features of SICC and imaging features which showed hypovascularity and progressive enhancement.SICC can present as a multilocular cyst on radiological images and it is necessary to distinguish this lesion from an atypical abscess.Simple surgical treatment is not the best treatment option for this disease.展开更多
Sarcomatoid carcinoma is a rare tumor that is composed of a mixture of malignant epithelial cells and mesenchymal cells.Many studies have reported that sarcomatoid carci-noma occurs in multiple organs including the li...Sarcomatoid carcinoma is a rare tumor that is composed of a mixture of malignant epithelial cells and mesenchymal cells.Many studies have reported that sarcomatoid carci-noma occurs in multiple organs including the liver.Sarco-matoid intrahepatic cholangiocarcinoma(S-iCCA)is an ex-tremely rare tumor that primarily occurs in the liver.This case occurred in a middle-aged man who was admitted to our hospital with abdominal pain.Enhanced computed to-mography of the abdomen showed a low-density mass in the upper right posterior lobe of the liver with enhancement in the periphery.Histological and immunohistochemical examination indicated that the tumor was malignant,with both cancer and sarcoma components,and was positive for cytokeratin and vimentin.The patient was diagnosed with S-iCCA.Metastases appeared in the liver and lung 4 months after surgery.Two cycles of chemotherapy were adminis-tered.Because of enlargement of the tumor,anti-angiogen-ic agents combined with immunotherapy were subsequently given to achieve disease control.To the best of our knowl-edge,this is the first reported case of a programmed cell death-1 inhibitor used in a S-iCCA patient.The purpose of this case report and literature review is to enhance clinician understanding of S-iCCA and to explore safe and effective treatment methods.展开更多
基金Supported by National Natural Science Foundation of China,No.81271629Medical Innovation Team of Wuxi City,No.CXTD002
文摘Sarcomatoid intrahepatic cholangiocarcinoma(SICC)is an extremely rare and highly invasive malignant tumor of the liver.To our knowledge,the imaging findings of sarcomatous cholangiocarcinoma have been rarely reported;and radiological features of this tumor mimicking liver abscess have not yet been reported.CASE SUMMARY We present a case of SICC mimicking liver abscess.The patient,a 43-year-old male,complained of repeated upper right abdominal discomfort and intermittent distension over a period of one month.Radiology examination revealed a huge focal lesion in the right liver.The lesion was hypointense on computed tomography with honeycomb enhancement surrounded by enhanced peripheral areas.It showed a hypo-signal on non-contrast T1-weighted images and a hypersignal on non-contrast T2-weighted images.Radiologists diagnosed the lesion as an atypical liver abscess.The patient underwent a hepatectomy.After surgery,he survived another 2.5 mo before passing away.A search of PubMed and Google revealed 43 non-repeated cases of SICC reported in 20 published studies.The following is a short review in order to improve the diagnostic and therapeutic skills in cases of SICC.CONCLUSION This report presents the clinical and radiological features of SICC and imaging features which showed hypovascularity and progressive enhancement.SICC can present as a multilocular cyst on radiological images and it is necessary to distinguish this lesion from an atypical abscess.Simple surgical treatment is not the best treatment option for this disease.
基金from State Project for Essential Drug Research and Development of the People’s Republic of China(No.2018ZX09303014)the Health and Family Planning Commission of Sichuan Province(No.18PJ194).
文摘Sarcomatoid carcinoma is a rare tumor that is composed of a mixture of malignant epithelial cells and mesenchymal cells.Many studies have reported that sarcomatoid carci-noma occurs in multiple organs including the liver.Sarco-matoid intrahepatic cholangiocarcinoma(S-iCCA)is an ex-tremely rare tumor that primarily occurs in the liver.This case occurred in a middle-aged man who was admitted to our hospital with abdominal pain.Enhanced computed to-mography of the abdomen showed a low-density mass in the upper right posterior lobe of the liver with enhancement in the periphery.Histological and immunohistochemical examination indicated that the tumor was malignant,with both cancer and sarcoma components,and was positive for cytokeratin and vimentin.The patient was diagnosed with S-iCCA.Metastases appeared in the liver and lung 4 months after surgery.Two cycles of chemotherapy were adminis-tered.Because of enlargement of the tumor,anti-angiogen-ic agents combined with immunotherapy were subsequently given to achieve disease control.To the best of our knowl-edge,this is the first reported case of a programmed cell death-1 inhibitor used in a S-iCCA patient.The purpose of this case report and literature review is to enhance clinician understanding of S-iCCA and to explore safe and effective treatment methods.
