# Intrabiliary Metastasis of Colon Cancer Mimicking Cholangiocarcinoma and Chemotherapy-Induced Sclerosing Cholangitis: A Case Report

## Authors

- Po-Yuan Chen ([ORCID](https://orcid.org/0000-0002-9236-4383)) — Department of Radiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
- Chien-Ming Chao ([ORCID](https://orcid.org/0000-0003-0235-9060)) — Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan
- Guang-Mao Lee ([ORCID](https://orcid.org/0000-0001-9702-7928)) — Department of Nursing, Kaohsiung Municipal United Hospital, Taiwan

## Article information

- **Journal:** The Ulutas Medical Journal (Ulutas Med J), ISSN 2149-388X
- **Issue:** Volume 8, Issue 2 (2022), pages 82–85
- **Article type:** Case Report
- **Published online:** 2022-06-09
- **DOI:** [10.5455/umj.20220222072137](https://doi.org/10.5455/umj.20220222072137)
- **Licence:** [CC BY-NC 4.0](https://creativecommons.org/licenses/by-nc/4.0/)
- **Article page:** https://www.ulutasmedicaljournal.com/?mno=87160
- **PDF:** https://www.ulutasmedicaljournal.com/pdf/87160.pdf

## Abstract

Intrabiliary metastasis of colon cancer without the involvement of the hepatic parenchyma is very rare and can cause biliary obstruction. We herein present a rare case of colon cancer metastasis that developed after right hemicolectomy and while undergoing chemotherapy. Computed tomography (CT) of the abdomen and percutaneous transhepatic cholangiography and drainage (PTCD) was performed because of obstructive jaundice. CT-guided biopsy showed high-grade atypical glands that were CK7(âˆ'), CK20(+), and CDX-2(+); metastatic adenocarcinoma would be considered first rather than cholangiocarcinoma. Clinicians should be aware that intrabiliary metastasis of colon cancer can mimic cholangiocarcinoma and chemotherapy-induced sclerosing cholangitis.

## Keywords

Intrabiliary metastasis; colon cancer; cholangiocarcinoma

## How to cite

Chen PY, Chao CM, Lee GM. Intrabiliary Metastasis of Colon Cancer Mimicking Cholangiocarcinoma and Chemotherapy-Induced Sclerosing Cholangitis: A Case Report. Ulutas Med J. 2022;8(2):82-85. doi:10.5455/umj.20220222072137

## References

1. Patel T. Increasing incidence and mortality of primary intrahepatic cholangiocarcinoma in the United States. Hepatology. 2001;33:1353–1357 https://doi.org/10.1053/jhep.2001.25087
2. Nagler J, Rochwarger AM. Metastatic colon carcinoma simulating primary bile duct carcinoma via endoscopic cholangiography. Gastrointest Radiol. 1977;2:75–76 https://doi.org/10.1007/bf02256470
3. Sandrasegaran K, Alazmi WM, Tann M, et al. Chemo therapy-induced sclerosing cholangitis. Clin Radiol. 2006;61:670–8 https://doi.org/10.1016/j.crad.2006.02.013
4. Shea WJ Jr, Demas BE, Goldberg HI, et al. Sclerosing cholangitis associated with hepatic arterial FUDR chemotherapy: Radiographic-histologic correlation. AJR Am J Roentgenol. 1986; 146:717–21 https://doi.org/10.2214/ajr.146.4.717
5. Kemeny N, Daly J, Oderman P, et al. Hepatic artery pump infusion: Toxicity and results in patients with metastatic colorectal carcinoma. J Clin Oncol. 1984; 2:595-600 85 77 Intrabiliary Metastasis of Colon Cancer Guang-Mao Lee et al. https://doi.org/10.1200/jco.1984.2.6.595
6. Akira K, Kazuyoshi O, Nobuyasu F, et al. Chemo therapy-Induced Sclerosing Cholangitis Caused by Systemic Chemotherapy, ACG Case Rep J 2019;6:1-4
7. Yamasaki S. Intrahepatic cholangiocarcinoma: macro scopic type and stage classification. J Hepato biliary Pancreat Surg 2003; 10:288-291 https://doi.org/10.1007/s00534-002-0732-8
8. Lee WJ, Lim HK, Jang KM, et al. Radiologic spectrum of cholangiocarcinoma: emphasis on manifestations and differential diagnoses. Radio Graphics 2001;21(spec issue):S97–S116 https://doi.org/10.1148/radiographics.21.suppl_1.g01oc12s97
9. Han JK, Choi BI, Kim AY, et al. Cholangiocarcinoma: pictorial essay of CT and cholangiographic findings. RadioGraphics 2002;22:173–187 https://doi.org/10.1148/radiographics.22.1.g02ja15173
10. Dong Y, Patel H, Patel C. Intrabiliary hepatic metastasis of colorectal carcinoma mimicking primary cholangio carcinoma: a case report and review of the literature. Case Rep Pathol. 2016; 4704781 https://doi.org/10.1155/2016/4704781
11. Tokai H, Kawashita Y, Eguchi S, et al. A case of mucin producing liver metastases with intrabiliary extension. World J Gastroenterol 2006; 12:4918–4921 https://doi.org/10.3748/wjg.v12.i30.4918
12. Scott J. Savader, Carol A. Prescott, Gunnar B. Lund, et al. Intraductal biliary biopsy: comparison of three techniques. J Vasc Interv Radiol 1996;7(5):743-50 https://doi.org/10.1016/s1051-0443(96)70843-6
13. Min Woo Lee. Fusion imaging of real-time ultrasono graphy with CT or MRI for hepatic intervention. Ultrasonography. 2014 Oct; 33(4): 227–239 https://doi.org/10.14366/usg.14021
14. Kim AY, Jeong WK. Intraductal malignant tumors in the liver mimicking cholangiocarcinoma: imaging features for differential diagnosis. Clin Mol Hepatol. 2016;22: 192–7 https://doi.org/10.3350/cmh.2016.22.1.192
15. Raquel A. Latorre Fragua, Alba Manuel Vazquez, Yuri Rodrigues Figueira, et al. Intrabiliary metastases in colorectal cancer: a systematic review. J Hepatobiliary Pancreat Sci (2019) 26:270–280 https://doi.org/10.1002/jhbp.635