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Intrahepatic cholangiocarcinoma in a worker at an offset color proof‐printing company: An autopsy case report
Author(s) -
Tomimaru Yoshito,
Kobayashi Shogo,
Wada Hiroshi,
Hama Naoki,
Kawamoto Koichi,
Eguchi Hidetoshi,
Kira Toshihiko,
Morii Eiichi,
Doki Yuichiro,
Mori Masaki,
Nagano Hiroaki
Publication year - 2015
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12363
Subject(s) - autopsy , offset (computer science) , offset printing , medicine , general surgery , computer science , materials science , inkwell , composite material , programming language
A 40‐year‐old Japanese man visited our hospital after test results indicated elevated hepatobiliary enzymes. He had worked at a printing plant for 8 years and been exposed to organic solvents, including 1,2‐dichloropropane (1,2‐ DCP ) and dichloromethane ( DCM ). Abdominal computed tomography ( CT ) showed an intrahepatic tumor with dilation of the intrahepatic bile duct. He was diagnosed with intrahepatic cholangiocarcinoma. He had no known risk factors for cholangiocarcinoma. Extended left hepatectomy with lymph node dissection was performed and the tumor was histologically diagnosed as well‐differentiated adenocarcinoma. A histological examination also showed biliary intraepithelial preneoplastic lesions in non‐cancerous liver areas. Two years after surgery, the patient developed jaundice, esophageal varices and ascites. A CT examination showed liver cirrhosis without recurrence of the cholangiocarcinoma. Although a liver transplantation was planned as a therapeutic option for his liver cirrhosis, his liver failure progressed rapidly and he died before transplantation could be performed. At autopsy, fibrosis was found in the whole liver, especially in the wall of the bile duct and periductal area suggesting chronic bile duct injury due to exposure to organic solvents. Taken together, the current case may suggest that exposure to organic solvents, including 1,2‐ DCP and DCM , is a risk factor for cholangiocarcinoma. Identifying risk factors for cholangiocarcinoma will help identify the mechanism and help prevent development of the disease.