Published online Feb 14, 2015. doi: 10.3748/wjg.v21.i6.1989
Peer-review started: June 26, 2014
First decision: August 6, 2014
Revised: September 11, 2014
Accepted: October 14, 2014
Article in press: October 15, 2014
Published online: February 14, 2015
Processing time: 230 Days and 7.7 Hours
We present a rare case of intrahepatic cholangiocarcinoma (ICC) with multiple skeletal muscle metastases. The patient was a 55-year-old Asian woman presenting with abdominal pain; abdominal and pelvic computed tomography and magnetic resonance cholangiopancreatography revealed an unresectable ICC with hepatic metastasis and metastastatic lymphadenopathy in the porto-caval area. After 3 mo of treatment with palliative radiotherapy and chemotherapy, magnetic resonance imaging of the thoracolumbar spine detected right psoas muscle and paraspinous muscle metastases. We performed an ultrasound-guided percutaneous fine-needle biopsy that confirmed a similar pattern of poorly differentiated adenocarcinoma. The patient treated with palliative chemotherapy and achieved 10 mo of survival. Here we report the first case quickly spread to multiple sites of muscle even though the three-month treatment, compare to the other cases reported muscle metastases at diagnosis.
Core tip: The case presented with multiple skeletal muscle metastases from an intrahepatic cholangiocarcinoma which only 5 cases have been reported so far.