A Case of Intrahepatic Cholangiocarcinoma without any Accumulation on Fluorine-18-Fluorodeoxy-Glucose Positron Emission Tomography Scan

Yukihiro Okuda, Hiroaki Terajima, Atsushi Yamada*, Fumio Konishi**, Yoshiyuki Kawakami, Yuki Hirose and Toshio Matsushita

Department of Surgery, Department of Radiology* and Department of Pathology**, Fukui Red Cross Hospital

A 69-year-old woman referred for epigastralgia was found in computed tomography, to have a solitary 3.5 cm hypovascular hepatic tumor localized at S8 and S4 closely adjoining the right and middle hepatic vein. US, CT, and MRI imaging studies and contrast medium enhancement patterns indicated intrahepatic cholangiocellular carcinoma, metastatic liver tumor, or sclerosing hemangioma. Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) showed that FDG had not accumulated in the tumor and standard uptake was very low at 2.4. The tumor was diagnosed histologically as adenocarcinoma with ultrasonically guided percutaneous biopsy. No malignant lesions were found in upper gastrointestinal endoscopy and total colonoscopy. Based on the preoperative diagnosis of intrahepatic cholangiocellular carcinoma, the patient underwent central bisegmentectomy with concomitant resection of the right hepatic vein and hepatic hilar lymph node dissection. Histopathological findings showed moderately differentiated cholangiocellular carcinoma without direct infiltration of the right hepatic vein. No lymph node metastases were observed.

Key words
intrahepatic cholangiocarcinoma, FDG-PET

Reprint requests
Yukihiro Okuda Department of Surgery, Fukui Red Cross Hospital
2-4-1 Tsukimi, Fukui, 918-8501 JAPAN

Accepted
July 23, 2008

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