Esophageal metastasis of stem cell-subtype hepatocholangiocarcinoma: Rare presentation of a rare tumor

Abstract

Hepatocholangiocarcinoma (cHCC-ICC) is a rare primary hepatic tumor defined by the presence of histological features of both hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). Its prevalence ranges from 1%-5% of all primary liver cancers. We report the case of a 55-year-old cirrhotic male patient admitted to our university hospital for dysphagia, revealing a 10 cm lower-third esophageal metastasis of an unresectable cHCC-ICC with stem-cell features. Computed tomography and abdominal magnetic resonance imaging scans revealed multiple hepatic lesions combining features of both HCC and ICC, associated with synchronous bone metastasis. Histological and immunohistochemical analyses of biopsies from the esophageal lesion and the hepatic tumor confirmed the diagnosis of cHCC-ICC with a stem cell-subtype, according to the World Health Organization classification. After a multidisciplinary meeting, the patient was treated with chemotherapy. He received two cycles of a gemcitabine plus cisplatin regimen before bone progression, and he died 3 mo after the initial diagnosis.

Breast Metastasis in a Patient with Primary Hepatocellular Carcinoma

“…Harada et al, reported a case of asymptomatic oesophageal metastasis, found on routine basis, in a patient with hepatocellular carcinoma, that underwent an oesophagectomy with thoracotomy and the biopsy showed metastasis from hepatocellular carcinoma, whereas, Salimon et al, reported a case of symptomatic oesophageal metastasis in a patient with hepatocholangiocarcinoma and dysphagia. The patient was treated with chemotherapy, contrary with the previous one [6,10]. Nugroho and Serra et al, reported cases of adrenal gland metastases from primary hepatocellular carcinoma, diagnosed with CT-guided biopsy, that were treated with chemotherapy [11,12] whereas, Zhigui Li et al, reported a case of a patient with multiple ectopic liver tissues along the pancreas, with development of hepatocellular carcinoma on these [15].…”

“…The incidence of hepatocellular carcinoma varies among geographical areas, with greater incidence being found in Asia, Taiwan, Korea, China and Japan [1][2][3][4][5][6][7]. Advanced hepatocellular carcinoma is one of the most lethal diseases and includes metastases to various organs, such as lungs, lymph nodes, musculoskeletal structures, peritoneal surface, gastrointestinal tract, spleen and pancreas [7][8][9][10]. It has only few systematic therapeutic options, with Sorafenib, being the most important pos administered molecular drug, that increases overall survival by approximately 3 months (10.7 months) compared with placebo (7.7 months) [6].…”

“…Hepatocellular carcinoma (HCC), is the 4 th most common neoplasm in men and 9th most common neoplasm in women, making it one of the leading causes of cancer-related deaths (approximately 600.000 deaths/year worldwide) [1][2][3][4][5][6][7][8][9][10][11][12]. Its geographical distribution varies according to the prevalence of known aetiologic factors such as HBV, HCV infection, alcohol, cirrhosis [12].…”

“…Its geographical distribution varies according to the prevalence of known aetiologic factors such as HBV, HCV infection, alcohol, cirrhosis [12]. Extrahepatic metastases occur in 14-37% of cases and are associated with poor prognosis (1 year survival<40%) [10,13] The most common extrahepatic HCC metastases sites are the lungs (49%), lymph nodes (41%), bone metastases (16%) and the adrenal glands (15%) Metastases occur via the portal vein system or via mediastinal nodes [2]. Breast Ca is the most commonly diagnosed cancer in the world, among women, and the second leading cause of cancer deaths, after lung cancer [14].…”