PMC6079478_01
Preoperative image.. Axial (a) and coronal (b) images acquired by preoperative contrast-enhanced computed tomography (CECT) revealed a perihilar tumor (arrows). (c) Contrast-enhanced magnetic resonance imaging showed a ring-enhanced tumor in liver segment VIII (dotted circle). (d) Magnetic resonance cholangiopancreatography revealed a perihilar tumor involving the bilateral extrahepatic bile ducts (arrow).
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Eighteen months after hemicolectomy, the patient had no complaint, but computed tomography (CT) revealed a hepatic portal tumor with right biliary tract dilatation (Fig. 1a, b). Magnetic resonance imaging and magnetic resonance cholangiopancreatography revealed a ring-enhanced low-intensity area in liver segment VIII involving the biliary tract (Fig. 1c, d).
Macroscopic examination of the resected specimen.. A 12-mm tumor in liver segment VIII, which invaded to the adjacent biliary tract and progressed along the right hepatic duct to the tumor thrombus was revealed.
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Macroscopic examination revealed that a 12-mm tumor had developed in liver segment VIII, invaded the adjacent biliary tract, and formed a tumor thrombus in the bile duct (Fig. 2).
Histopathological examination.. (a) Both the liver tumor and bile duct tumor thrombus comprised moderately differentiated tubular adenocarcinoma (HE staining, 200x). (b) Histopathological findings of primary colon cancer (HE staining, 200x). Overall, these findings indicated that the liver tumor was compatible with metastatic disease from colon carcinoma.
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Microscopic examination showed that both the liver tumor and BDTT comprised moderately differentiated tubular adenocarcinoma (Fig. 3).
Postoperative image six months after hepatectomy.. Axial (a) and coronal (b) images acquired by contrast-enhanced computed tomography (CECT) at six months after hepatectomy revealed recurrence in the biliary tract on the hepaticojejunostomy (arrow) with intra-hepatic bile duct dilatation.
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A CT scan showed a recurrent tumor developing in the biliary tract on the hepaticojejunostomy and intra-hepatic bile duct dilatation (Fig. 4).