Korean J Med.  2008 Nov;75(5):569-573.

A case of intrahepatic sarcomatoid cholangiocarcinoma with huge right ventricular tumor thrombus

• Hong KS
• Kim IK
• Lee JK
• Kim JW
• Kim H
• Hwang JH

Abstract

A 69-year-old female patient presented with a huge liver mass at another hospital. Computed tomography (CT) revealed a huge, well-demarcated, low-attenuated mass in the right lobe of the liver and multiple nodules in both lungs. The liver mass invaded the colon at the hepatic flexure and infiltrated into the retroperitoneum. Spiral CT revealed a huge tumor thrombus in the right ventricle (RV). The enhancement pattern of the right ventricular mass was identical to that of the liver mass. After ultrasonography-guided needle biopsy of the liver mass, the patient was diagnosed with intrahepatic sarcomatoid cholangiocarcinoma. Although we recommended debulking open-heart surgery for the prevention of sudden death caused by massive pulmonary embolism, the patient and her family opted against surgery due to high operation-related mortality and old age. The patient later died of massive pulmonary embolism at another hospital a few weeks later.

Keyword

Intrahepatic sarcomatoid cholangiocarcinoma; Pulmonary embolism; Right ventricular thrombosis; Spindle cell; Tumor thrombus

MeSH Terms

Aged
Biopsy, Needle
Cholangiocarcinoma
Colon
Death, Sudden
Female
Heart Ventricles
Humans
Liver
Lung
Pulmonary Embolism
Thrombosis
Tomography, Spiral Computed