Ma QJ, Wang FH, Yang NN, Wei HL, Liu F. Rare primary squamous cell carcinoma of the intrahepatic bile duct: A case report and review of literature. World J Clin Oncol 2024; 15(7): 936-944 [PMID: 39071465 DOI: 10.5306/wjco.v15.i7.936]
Corresponding Author of This Article
Fu-Hai Wang, MD, Surgeon, Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, No. 16766 Jingshi Road, Jinan 250014, Shandong Province, China. 2139@sdhospital.com.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Jul 24, 2024; 15(7): 936-944 Published online Jul 24, 2024. doi: 10.5306/wjco.v15.i7.936
Rare primary squamous cell carcinoma of the intrahepatic bile duct: A case report and review of literature
Qing-Jun Ma, Fu-Hai Wang, Ning-Ning Yang, Hong-Long Wei, Feng Liu
Qing-Jun Ma, Fu-Hai Wang, Hong-Long Wei, Feng Liu, Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong Province, China
Ning-Ning Yang, Department of Respiratory and Critical Care Medicine, Shandong Provincial Chest Hospital Affiliated to Shandong University, Jinan 250013, Shandong Province, China
Co-first authors: Qing-Jun Ma and Ning-Ning Yang.
Author contributions: Ma QJ and Yang NN designed the report and wrote the paper, they contributed equally to this manuscript; Wang FH and Liu F performed the surgery; Wei HL collected the patient’s clinical data; Wang FH analyzed the data and revised the paper; all authors have read and approved the final version of this manuscript.
Supported bythe Youth Science Foundation Grant Program of Shandong First Medical University, No. 202201-091.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4. 0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons. org/Licenses/by-nc/4.0/
Corresponding author: Fu-Hai Wang, MD, Surgeon, Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, No. 16766 Jingshi Road, Jinan 250014, Shandong Province, China. 2139@sdhospital.com.cn
Received: February 26, 2024 Revised: June 3, 2024 Accepted: June 25, 2024 Published online: July 24, 2024 Processing time: 140 Days and 14.9 Hours
Abstract
BACKGROUND
Cholangiocarcinoma is the most common malignancy of the biliary tree and has a poor prognosis. Adenocarcinoma is the most common pathological type of cholangiocarcinomas, but rare squamous, adenosquamous, and mucinous variants have been reported without adequate clinical data.
CASE SUMMARY
This report describes a rare case of primary squamous cell carcinoma (SCC) of the intrahepatic bile duct. The patient was admitted with a tumor in the hepatic caudate lobe with no obvious clinical symptoms. Examination revealed hepatitis B surface antigen positivity, a slight increase in alfa-fetoprotein to 16.34 ng/mL, and an irregular slightly heterogeneous enhancing lesion in the hepatic caudate lobe, which was initially thought to be hepatocellular carcinoma. Laparoscopic resection was performed, and the final pathology suggested a rare primary SCC of the intrahepatic bile duct. Immunohistochemistry indicated positivity for villin, partial positivity for p63, and negativity for hepatocyte, CK7, CK8, CK19, and CK20. The Ki-67 index was approximately 60%. The patient received six cycles of Tegio chemotherapy. A new lesion was detected in the liver after 15 months. The surgery was performed, and the patient was followed-up at a local hospital. To date, no new lesions have been observed.
CONCLUSION
Surgery is the first choice for resectable lesions, and combined chemotherapy based on pathology is essential for increasing overall survival.
Core Tip: We report a case of primary intrahepatic biliary squamous cell carcinoma (SCC) that was initially considered hepatocellular carcinoma. Intrahepatic biliary SCC is a rare pathological type without typical imaging features or serum markers. Its diagnosis depends on biopsy or postoperative pathology. Surgical resection is still considered the first choice for resectable lesions, but the intraoperative pathology of atypical liver lesions is essential for radical resection. Combined chemotherapy or chemoradiotherapy is beneficial for prolonging overall survival and decreasing the risk of recurrence. This case report and related literature review provide a valuable reference for the diagnosis and treatment of this disease.
