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Hepatic sarcoidosis mimicking cholangiocellular carcinoma: A case report and literature review

INTRODUCTION: Sarcoidosis is a multisystem disease characterized by the presence of non-caseating granulomas in affected organs. Almost 70% of patients with a sarcoidosis reaction have hepatic involvement. However, evidence-based clinical management or treatment strategies for hepatic sarcoidosis ar...

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Detalles Bibliográficos
Autores principales: Miyamoto, Ryoichi, Sano, Naoki, Tadano, Sosuke, Inagawa, Satoshi, Adachi, Shinya, Yamamoto, Masayoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686224/
https://www.ncbi.nlm.nih.gov/pubmed/29080443
http://dx.doi.org/10.1016/j.ijscr.2017.10.032
Descripción
Sumario:INTRODUCTION: Sarcoidosis is a multisystem disease characterized by the presence of non-caseating granulomas in affected organs. Almost 70% of patients with a sarcoidosis reaction have hepatic involvement. However, evidence-based clinical management or treatment strategies for hepatic sarcoidosis are poorly defined. Here, we present a case of a resected hepatic sarcoidosis patient. Additionally, we review the relevant hepatic sarcoidosis literature and discuss the clinical management of hepatic sarcoidosis. PRESENTATION OF CASE: A 20-mm liver tumor of segment 8 was incidentally detected in a 64-year-old female. Radiological images resembled the enhancement pattern of cholangiocellular carcinoma. Thus, this lesion was assigned a preoperative classification of pT1N0M0 stage I according to the 7th Union for International Cancer Control guidelines. The patient underwent a partial liver resection. Histologically, the tumor contained sarcoidosis lesions indicated by a conglomerate of epithelioid granulomas with giant cells. These histopathological findings were consistent with the diagnosis of hepatic sarcoidosis. DISCUSSION: Histopathological examination has been established as the definitive diagnostic tool for hepatic sarcoidosis. Therefore, liver biopsy or surgical resection of a liver tumor should be considered in cases that are difficult to preoperatively distinguish from malignant tumors. CONCLUSION: We present the case of a patient with surgically resected hepatic sarcoidosis that was difficult to preoperatively distinguish from cholangiocellular carcinoma.