Cholangiolocellular Carcinoma Misdiagnosed As Hemangioma: Unique Central Fibrotic Area Devoid of Cancer Cells Detected on a Seven-Year Follow-Up.

Autor:	Shao W; Department of Molecular Pathology, Tokushima University, Tokushima, JPN., Kamo H; Department of Surgery, Taoka Hospital, Tokushima, JPN., Yoshioka K; Department of Surgery, Taoka Hospital, Tokushima, JPN., Izumi K; Department of Pathology and Laboratory Medicine, Tokushima University, Tokushima, JPN., Tsuneyama K; Department of Pathology and Laboratory Medicine, Tokushima University, Tokushima, JPN.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Nov 05; Vol. 16 (11), pp. e73091. Date of Electronic Publication: 2024 Nov 05 (Print Publication: 2024).
DOI:	10.7759/cureus.73091
Abstrakt:	Cholangiolocellular carcinoma, a subtype of peripheral-type intrahepatic cholangiocarcinoma, is a relatively rare primary liver tumor. This case report describes a patient with cholangiolocellular carcinoma that was initially misdiagnosed as hemangioma, and ultimately underwent complete tumor resection after a seven-year follow-up period. A 72-year-old female patient with a history of chronic hepatitis C was followed up regularly at the hospital. Computed tomography (CT) performed seven years prior had detected a small tumor (12 mm) with radiographic characteristics suggestive of hemangioma. The tumor increased in size from 12 to 32 mm over the next seven years. On CT, the tumor showed poor central enhancement, indicating reduced blood flow in the central region. Due to the suspicion of malignancy, partial surgical resection was performed. Pathological examination confirmed a diagnosis of cholangiolocellular carcinoma. The carcinoma exhibited vascular invasion and a broad central fibrous area with hyalinization, lacking epithelial cells, and marked by venous obstruction. This case underscores the challenge of distinguishing cholangiolocellular carcinoma from hemangioma, particularly in small tumors with similar radiological features. The findings highlight the importance of employing additional diagnostic modalities such as ultrasound and magnetic resonance imaging, as well as the necessity of biopsy when suspicion arises. This case also describes the unique finding of a central fibrous area without tumor cells, which may have resulted from localized circulatory disturbances potentially caused by tumor embolism in the portal and hepatic veins. This pathological finding provides valuable insights into the nature of this rare tumor. Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Ethics Review Committee for Clinical Training, Taoka Hospital issued approval TH-515-2017. Informed consent was obtained from the patient and her eldest daughter on May 15, 2017. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Shao et al.)
Databáze:	MEDLINE
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