Bone metastasis from cholangiocarcinoma mimicking osteosarcoma: A case report and review literature

Abstract

Cholangiocarcinoma is an aggressive tumor of the hepatic biliary system and it commonly spreads to the regional lymph nodes, liver and lungs. However, bone metastasis from cholangiocarcinoma is rare compared with other tumors. We herein present the case of a 61-year-old Asian woman who presented with pain in the right scapular area. Magnetic resonance imaging revealed bone destruction and an adjacent soft tissue mass at the right scapula. The findings on computed tomography imaging were compatible with cholangiocarcinoma. Bone biopsy was performed and the diagnosis of cholangiocarcinoma with bone metastasis was confirmed. The survival time was 10 months, despite administration of palliative radiotherapy and chemotherapy. Therefore, bone metastasis from cholangiocarcinoma should be considered as a differential diagnosis in patients who present with an osteolytic bone lesion and a liver mass.

Pathological Clavicle Fracture: Initial Presentation of Intrahepatic Cholangiocarcinoma

“…There are very few publications in the literature reporting bone metastasis secondary to ICC [9][10][11][12]15]. In the literature, Carlisle et al, Lahrach et al, and Federico et al reported metastatic humeral fractures related to ICC [9][10][11].…”

“…MacKenzie et al treated distal femoral metastasis with en bloc resection and tumor prosthesis in a patient with known ICC [14]. Chindaprasirt et al presented an ICC case with scapular bone and surrounding soft metastasis [15]. As can be seen, there are very few publications in the literature reporting cases of bone metastasis due to ICC.…”

Cutaneous Cholangiocarcinoma: An Interesting Presentation

“…Dowsiriroj et al 6 reported 55 cases of spinal metastases from CCA, with a median survival of only 4.0 months. Chindaprasirt et al 4 documented 5 cases of metastases to the appendicular skeleton, most commonly the humerus, and 1 case of metastasis to the scapula, with survival ranging from 4 weeks to 1 year. Liu et al 7 compiled a literature review of 30 patients with cutaneous metastases, most commonly to the scalp, also with a median survival of 4.0 months.…”

“…Cholangiocarcinoma most commonly metastasizes to other locations in the liver, regional lymph nodes, or the lung; however, metastasis to the bone have been described in rare cases. 4 Curative treatment may only be obtained through surgical resection; however, even in patients with an R0 resection, recurrence rates remain high, between 49% and 64%. 3 Chemotherapy in unresectable disease may be used for palliative measures.…”

Paraparesis and Disseminated Osteolytic Lesions Revealing Cholangiocarcinoma: A Case Report

“…Few cases of bone metastasis from CCA are described in the literature, and the most commonly reported sites were the humerus, the fibula, the femoral bone [ 8 ], and the scapula [ 9 - 11 ]. In our case, multiple osteolytic lesions with a malignant aspect were discovered in the coxal bone, the sacrum, and the left proximal femoral region, as well as in the calvarium and spine.…”