Distal fibula metastasis of cholangiocarcinoma

Cholangiocarcinoma is a rare disease with a reported incidence in the United States of 1 to 2 cases per 100,000 population. These cancers have a high mortality rate because most are locally advanced at presentation. Cholangiocarcinoma most commonly advances locally and regionally by invading the lymph nodes. In rare cases, it has been noted that cholangiocarcinoma can metastasize to bone, with a preponderance for the axial skeleton. Herein, we describe what we believe to be the first clinical report of an acral bone metastasis from metastatic cholangiocarcinoma.