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Unrecognized intrahepatic cholangiocarcinoma: an analysis of 993 adult cirrhotic liver explants
Author(s) -
Vallin Mélanie,
Sturm Nathalie,
Lamblin Géraldine,
Guillaud Olivier,
Hilleret MarieNoëlle,
Hervieu Valérie,
Joubert Juliette,
Abergel Armand,
Leroy Vincent,
Boillot Olivier,
Dumortier Jérôme,
Scoazec JeanYves
Publication year - 2013
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12108
Subject(s) - medicine , cirrhosis , hepatocellular carcinoma , liver transplantation , gastroenterology , milan criteria , context (archaeology) , transplantation , risk factor , intrahepatic cholangiocarcinoma , paleontology , biology
Liver cirrhosis is a recognized risk factor for intrahepatic cholangiocarcinoma (I‐ CC a). Small I‐ CC a nodules might be undiagnosed or misdiagnosed as hepatocellular carcinoma ( HCC ) in the context of liver cirrhosis. The aim of this study was to determine the prevalence and clinical impact of undetected I‐ CC a in liver explants of adult cirrhotic patients undergoing liver transplantation ( LT ). From December 1985 to November 2008, a first LT was performed in 993 adult cirrhotic patients in three French academic Hospitals. All liver explants were analyzed for the presence of nodules. The diagnosis of HCC was made in 331 cases (33.3% of the patients). Similarly, an I‐ CC a was identified in 10 (1%) patients, with a mean size of 31 ± 17 mm. The mean age at transplantation was 58.8 yr (range 45 – 66), and all the patients were men. The mean follow‐up after LT was 33 months (range 4–52). Post‐transplant tumor recurrence was observed in five patients (50%), after a mean delay of 10 months. All five patients died. Malignant recurrence was associated with the presence of venous emboli on liver explants. Our results suggest that unrecognized I‐ CC a complicating liver cirrhosis is a rare entity, associated with high risk of recurrence and poor prognosis.