Distant skeletal muscle metastasis from intrahepatic cholangiocarcinoma presenting as Budd-Chiari syndrome

Figure 1 Computed tomo-graphy shows a large mass with rim enhancement around intrahepatic portion IVC of liver which encircles IVC (black arrow). Metastatic lesions seen in the left spinal erector muscle (white arrow) and right psoas muscle (not shown).

Figure 2 A, B: Neoplastic glandular infiltration in the skeletal muscle, suggesting metastatic adenocarcinoma. (HE, x 100 and x 200); C: Neoplastic glands are positive for immunohistochemical staining on CEA (CEA immunostain, x 200); D: Neoplastic glands are positive for immunohistochemcal staining on cytokeratin 7 (Cytokeratin 7 immunostain, x 200).