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Calcification in mucinous cholangiocellular carcinoma.
S Nagakura1, Y Shirai, K Yamai
1Department of Surgery, Niigata University School of Medicine, Japan.
Hepato-Gastroenterology
|May 6, 1999
Summary
Calcification is uncommon in cholangiocellular carcinoma. This case highlights that mucinous cholangiocarcinoma can present with coarse calcification, a finding that may mimic hepatolithiasis on imaging.
Area of Science:
- Hepatobiliary Surgery
- Gastroenterology
- Oncology
Background:
- Cholangiocarcinoma (CCA) is a primary malignancy of the bile duct epithelium.
- Calcification is an infrequent finding in cholangiocarcinoma, often leading to misdiagnosis.
- Mucinous adenocarcinoma is a subtype of cholangiocarcinoma characterized by abundant mucin production.
Observation:
- A 53-year-old male presented with imaging findings suggestive of hepatolithiasis due to coarse calcified foci.
- Intraoperative cholangioscopy during laparotomy revealed no gallstones but identified an unsuspected tumor.
- The tumor was characterized by abundant mucin and histological confirmation of mucinous adenocarcinoma with calcification.
Findings:
- This report details a rare case of cholangiocellular carcinoma with significant calcification.
- A review of English literature identified 9 cases of cholangiocarcinoma with macroscopic calcification.
- The majority (6/9) of these reported cases were mucinous adenocarcinomas, with coarse calcification noted in 7 cases.
Implications:
- Clinicians should consider cholangiocarcinoma, particularly the mucinous variant, in the differential diagnosis of biliary calcifications.
- Preoperative imaging showing coarse calcification can be misleading, necessitating intraoperative assessment.
- Awareness of calcification in cholangiocarcinoma can improve diagnostic accuracy and patient management.