Distant Cutaneous Metastasis as the First Sign of Recurrence After R0 Resection of Intrahepatic Cholangiocarcinoma: A Case Report.
- 1Department of Surgery, Yokosuka Kyosai Hospital, Yokosuka, JPN.
- 2Department of Gastroenterological Surgery, Yokohama City University, Yokohama, JPN.
- 3Department of Gastrointestinal Surgery, Yokosuka Kyosai Hospital, Yokosuka, JPN.
Abstract
Cutaneous metastasis from cholangiocarcinoma is rare and typically occurs at surgical incision sites or along drainage tracts due to tumor implantation, whereas distant cutaneous metastasis unrelated to surgical procedures is extremely uncommon and generally indicates a poor prognosis. We report the case of a 65-year-old man who was diagnosed with intrahepatic cholangiocarcinoma after a low-density lesion was detected in the left lateral liver segment during postoperative surveillance following nephrectomy for renal cell carcinoma. He underwent left hepatectomy with caudate lobectomy and hepatoduodenal ligament lymphadenectomy, and pathological examination revealed pT2N0M0, stage II disease (AJCC 8th edition). No adjuvant chemotherapy was administered. Eight months after surgery, a painless, mobile subcutaneous mass appeared on the right posterior trunk and was clinically diagnosed as a lipoma. At 14 months postoperatively, the lesion became painful, and partial excision at another hospital revealed a metastatic cutaneous tumor. Subsequent FDG-PET/CT demonstrated uptake in the cutaneous lesion as well as in the right iliac and left femoral bones. Immunohistochemical findings supported cutaneous metastasis from intrahepatic cholangiocarcinoma. The patient received radiotherapy for bone metastasis and systemic chemotherapy, but despite temporary disease control, his condition gradually deteriorated, and he died 56 months after surgery. This case highlights that distant cutaneous metastasis from intrahepatic cholangiocarcinoma may initially present as a benign-appearing postoperative subcutaneous mass and can be easily overlooked. Because cutaneous lesions are readily accessible for diagnostic evaluation, newly developed postoperative subcutaneous masses should be carefully assessed even when serum tumor markers and imaging studies show no evidence of recurrence.
Related
- A prognostic model combining hilar lymph node metastasis and preoperative anemia to predict outcomes after curative resection of intrahepatic cholangiocarcinoma.
- Synchronous hepatocellular carcinoma and IPNB-associated intrahepatic cholangiocarcinoma in a patient with resolved viral hepatitis: a case report of diagnostic pitfall and margin-negative resection
- Number of examined lymph nodes and overall survival in intrahepatic cholangiocarcinoma: a population-based study suggesting a staging benefit
- OLFM4 promotes intrahepatic cholangiocarcinoma progression through a PKM2-glycolysis-histone lactylation feedback loop.
- Same organ, divergent immunity: T-cell exhaustion versus stromal exclusion in hepatocellular carcinoma and intrahepatic cholangiocarcinoma
BibTeX
@article{takeshita2026distant,
title = {{Distant Cutaneous Metastasis as the First Sign of Recurrence After R0 Resection of Intrahepatic Cholangiocarcinoma: A Case Report.}},
author = {Yusuke Takeshita and Kazunori Nojiri and Naoki Maeda and Hidenobu Masui and Takafumi Kumamoto},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116987},
url = {https://europepmc.org/article/MED/42948021},
note = {CC BY},
}
RIS
TY - JOUR
TI - Distant Cutaneous Metastasis as the First Sign of Recurrence After R0 Resection of Intrahepatic Cholangiocarcinoma: A Case Report.
AU - Yusuke Takeshita
AU - Kazunori Nojiri
AU - Naoki Maeda
AU - Hidenobu Masui
AU - Takafumi Kumamoto
PY - 2026
DA - 2026/09/27
JO - Cureus
DO - 10.7759/cureus.116987
UR - https://europepmc.org/article/MED/42948021
AB - Cutaneous metastasis from cholangiocarcinoma is rare and typically occurs at surgical incision sites or along drainage tracts due to tumor implantation, whereas distant cutaneous metastasis unrelated to surgical procedures is extremely uncommon and generally indicates a poor prognosis. We report the case of a 65-year-old man who was diagnosed with intrahepatic cholangiocarcinoma after a low-density lesion was detected in the left lateral liver segment during postoperative surveillance following nephrectomy for renal cell carcinoma. He underwent left hepatectomy with caudate lobectomy and hepatoduodenal ligament lymphadenectomy, and pathological examination revealed pT2N0M0, stage II disease (AJCC 8th edition). No adjuvant chemotherapy was administered. Eight months after surgery, a painless, mobile subcutaneous mass appeared on the right posterior trunk and was clinically diagnosed as a lipoma. At 14 months postoperatively, the lesion became painful, and partial excision at another hospital revealed a metastatic cutaneous tumor. Subsequent FDG-PET/CT demonstrated uptake in the cutaneous lesion as well as in the right iliac and left femoral bones. Immunohistochemical findings supported cutaneous metastasis from intrahepatic cholangiocarcinoma. The patient received radiotherapy for bone metastasis and systemic chemotherapy, but despite temporary disease control, his condition gradually deteriorated, and he died 56 months after surgery. This case highlights that distant cutaneous metastasis from intrahepatic cholangiocarcinoma may initially present as a benign-appearing postoperative subcutaneous mass and can be easily overlooked. Because cutaneous lesions are readily accessible for diagnostic evaluation, newly developed postoperative subcutaneous masses should be carefully assessed even when serum tumor markers and imaging studies show no evidence of recurrence.
SN - 2168-8184
ER -