A case of liver metastasis with biliary invasion from colorectal cancer which was detected by diagnostic imaging techniqes

Abstract

The patient was an 85-year-old man who had undergone surgeries for descending colon cancer in 2004, transverse colon cancer in 2005 and rectal cancer in 2006. In June 2007, a CT scan of the abdomen showed a heterogeneous tumor in the lateral segment of the liver, accompanied by biliary dilatation. Cholangiocellular carcinoma was suspected. In November 2007, left hepatic lobectomy was performed because the biliary dilatation had extended to near the umbilical portion of the portal vein. Histopathological examination showed that moderately differentiated adenocarcinoma proliferated along the epithelium of the bile duct. On immunohistochemical studies, the tumor was negative for cytokeratin 7 and positive for cytokeratin 20 which were similar to those of the transverse colon cancer that had been resected in 2006. Metastasis from transverse colon cancer was thus diagnosed. It is rare to detect biliary invasion on diagnostic imaging studies in a patient with liver metastases from colorectal cancer, and so far only 11 such cases have been reported in Japan.