Intrahepatic Cholangiocarcinoma Initially Presented as a Distant Metastatic Lymph Node without Demonstrable Hepatic Mass: A Case Report

Abstract

This report describes a rare case of intrahepatic cholangiocarcinoma, initially presented as a distant metastatic lymph node without demonstrable hepatic mass, in a 37-year-old man. Initially, a solitary cystic mass around the common hepatic artery was detected; two years later, a mass-forming intrahepatic cholangiocarcinoma developed in the left lobe of the liver. The cystic mass showed no change in shape and size for two years, which was then confirmed as a distant metastatic lymph node of cholangiocarcinoma after surgery. This was an extraordinary clinical manifestation of the intrahepatic cholangiocarcinoma, which presented as a cavity lymphadenopathy with unknown primary site, in addition to favorable clinical course with stable size and shape for 2 years. After literature reviews, we discuss in this paper the possible mechanism of cancer of unknown primary in intrahepatic cholangiocarcinoma, and the prognostic factors involved.

Keywords

• cholangiocarcinoma
• lymph nodes
• metastasis
• prognosis