Gradually progressive cholangiolocellular carcinoma: a case report

Area of Science:

• Hepatobiliary Medicine
• Surgical Oncology
• Diagnostic Imaging

Background:

• Cholangiolocellular carcinoma (CoCC) is a rare primary liver tumor.
• Distinguishing CoCC from benign liver lesions like hemangioma can be challenging.
• This report details a case of slow-growing CoCC managed over five years.

Purpose of the Study:

• To present a case of a slow-growing cholangiolocellular carcinoma.
• To highlight diagnostic challenges in differentiating CoCC from hemangioma.
• To emphasize the importance of follow-up for small hepatic tumors.

Main Methods:

• A 66-year-old male patient with a history of pseudo-tumors was monitored for a small liver lesion.
• Serial computed tomography (CT) scans showed tumor growth from 10 mm to 20 mm over 5 years.
• Advanced imaging including positron emission tomography CT and magnetic resonance imaging (MRI) was performed, followed by left hepatectomy for diagnosis.

Main Results:

• Radiological findings were initially suggestive of hemangioma.
• Positron emission tomography CT showed fluorodeoxyglucose uptake (SUV max 5.3).
• MRI revealed characteristic signal intensities, and pathological examination confirmed CoCC. The patient recovered well and showed no recurrence after one year.

Conclusions:

• Small CoCC and hemangioma can present with similar radiological features, complicating diagnosis.
• CoCC should be considered in the differential diagnosis of small, potentially benign hepatic tumors.
• Regular radiological follow-up is essential for early detection and management of such lesions.