Jiao X, Zhai MM, Xing FZ, Wang XL. Simultaneously metastatic cholangiocarcinoma and small intestine cancer from breast cancer misdiagnosed as primary cholangiocarcinoma: A case report. World J Clin Cases 2023; 11(18): 4446-4453 [PMID: PMC10336993 DOI: 10.12998/wjcc.v11.i18.4446]
Corresponding Author of This Article
Xiao-Ling Wang, MNurs, Chief Nurse, Department of Gastrointestinal Surgery, Affiliated Hospital of Weifang Medical University, No. 2428 Yuhe Road, Kuiwen District, Weifang 261041, Shandong Province, China. wangxiaolingfly@126.com
Research Domain of This Article
Oncology
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 Cases. Jun 26, 2023; 11(18): 4446-4453 Published online Jun 26, 2023. doi: 10.12998/wjcc.v11.i18.4446
Simultaneously metastatic cholangiocarcinoma and small intestine cancer from breast cancer misdiagnosed as primary cholangiocarcinoma: A case report
Xin Jiao, Mi-Mi Zhai, Fang-Zhou Xing, Xiao-Ling Wang
Xin Jiao, Fang-Zhou Xing, Xiao-Ling Wang, Department of Gastrointestinal Surgery, Affiliated Hospital of Weifang Medical University, Weifang 261041, Shandong Province, China
Mi-Mi Zhai, Department of Digestive System, Weifang People’s Hospital, Weifang 261041, Shandong Province, China
Author contributions: Jiao X reviewed the literature and contributed to manuscript drafting; Xing FZ was the patient’s primary doctor and substantially contributed to the conception and design of the study and acquisition of data; Zhai MM substantially contributed to data acquisition; Wang XL was responsible for revision of the manuscript for important intellectual content.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this case report.
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: Xiao-Ling Wang, MNurs, Chief Nurse, Department of Gastrointestinal Surgery, Affiliated Hospital of Weifang Medical University, No. 2428 Yuhe Road, Kuiwen District, Weifang 261041, Shandong Province, China. wangxiaolingfly@126.com
Received: April 29, 2023 Peer-review started: April 29, 2023 First decision: May 15, 2023 Revised: May 23, 2023 Accepted: May 26, 2023 Article in press: May 26, 2023 Published online: June 26, 2023 Processing time: 58 Days and 4.2 Hours
Abstract
BACKGROUND
Cholangiocarcinoma and small intestine cancer are common clinical malignancies, but metastatic cholangiocarcinoma and small intestine cancer are rare, especially simultaneous metastatic cholangiocarcinoma and small intestine cancer from breast cancer. Since the clinical presentation of metastatic cholangiocarcinoma and small intestine cancer does not differ from primary tumor, it may lead to misdiagnosis preoperatively.
CASE SUMMARY
A 66-year-old woman was admitted to our hospital for further treatment due to abdominal pain and jaundice. Abdominal magnetic resonance imaging and magnetic resonance cholangiopancreatography showed an occupying lesion of the bile duct, considering a high possibility of primary bile duct tumor. Therefore, we performed a radical bile duct cancer surgery and cholecystectomy, and multiple tumors in the small intestine were found and removed during the surgery process. Postoperative pathology showed metastatic bile duct cancer and small intestine cancer from tumors in other parts. The patient underwent a right total mastectomy and axillary lymph node dissection because of right breast cancer 2 years ago. Combining with the immunohistochemical results, the patient was finally diagnosed as metastatic cholangiocarcinoma and metastatic small intestine cancer from breast cancer. Postoperatively, the patient received four cycles of chemotherapy and targeted therapy with docetaxel, capecitabine and trastuzumab. Unfortunately, the patient eventually died from tumor progression, thoracoabdominal infection, and sepsis 5 mo after surgery.
CONCLUSION
Simultaneous metastatic cholangiocarcinoma and small intestine cancer from breast cancer are rare and the prognosis is extremely poor. Improving preoperative diagnostic accuracy is beneficial to avoid excessive surgical treatment. Treatment should be aimed at relieving biliary obstruction and abdominal pain, and then supplemented with chemotherapy and targeted therapy to control tumor progression and prolong the patient’s life.
Core Tip: Simultaneous metastatic cholangiocarcinoma and small intestine cancer from breast cancer are rare. We present a rare case of bile duct and small intestine metastasis from breast cancer in an older patient who died 5 mo after undergoing radical cholangiocarcinoma surgery due to extensive abdominal metastases and sepsis. Improving preoperative accuracy is necessary, and treatment should be aimed at relieving biliary obstruction and abdominal pain.
