Liver metastases of colorectal adenocarcinoma with intrahepatic biliary spread pattern: clinical manifestation and importance of immunohistochemical analysis

Liver metastases of colorectal carcinoma (LMCC) with macroscopic intrabiliary ductal involvement are a rare entity that can clinically and radiologically mimic a cholangiocarcinoma. However, a thorough anatomopathologic and immunohistochemical study of biliary ductal involvement is required because of its distinctive clinical features and relatively indolent biological behavior, reflecting a better prognosis and long-term survival. We present the case of a patient who debuted with LMCC with intrahepatic biliary ductal involvement, whose definitive diagnosis was established by immunohistochemical analysis, showing a characteristic CK7 - /CK20 + pattern.

Automated summary

Liver metastases of colorectal carcinoma (LMCC) with macroscopic intrabiliary ductal involvement can clinically and radiologically mimic a cholangiocarcinoma. However, a thorough anatomopathologic and immunohistochemical study is required to differentiate due to the distinctive clinical features and relatively indolent biological behavior of LMCC, which reflect a better prognosis and long-term survival. We present a case of LMCC with intrahepatic biliary ductal involvement, diagnosed definitively through immunohistochemical analysis showing a characteristic CK7 - /CK20 + pattern.