Successful liver resection for the unusual case of peripheral intra bile duct growth of liver metastasis from colorectal carcinoma

Abstract

Peripheral intrabiliary liver metastases (PILM) from colorectal carcinoma are rare, and this feature, which resembles primary cholangiocarcinoma, potentially misleads the accurate diagnosis and subsequent surgical treatment. A 67-year-old man with a medical history of descending colon carcinoma demonstrated an abnormal rise in CA19-9. There was a strong possibility of peripheral cholangiocarcinoma, because Computed tomography detected tumour infiltration into bile duct three. The patient underwent anatomic segment eight and lateral lobe resection. Pathological findings revealed that every tumour was metastatic liver carcinoma due to descending colon carcinoma. Cases of liver metastasis which resemble peripheral cholangiocarcinoma might be difficult to distinguish preoperatively. The correct diagnosis is important in making decisions regarding the surgical management of such patients. Nonanatomic hepatectomy is often performed for liver metastases from colorectal carcinomas. Anatomic hepatectomy, however, should be recommended in cases of PILM.