Intrahepatic cholangiocarcinoma (ICC) is a cancer of the bile duct in the liver. The clear cell subtype of ICC is a rare cancer; until now, only 8 cases have been reported. The number of reports is so small that a detail description of clear cell ICC is valuable.
A case report will be published on May 28, 2010 in the World Journal of Gastroenterology addresses this question. The diagnostic pathology team led by Associate Professor Dr. Hayashi at the Department of Pathology, Nagasaki University Hospital in Japan collaborated with Professor Nagayasu, Department of the 1st Surgery and Professor Uetani, Department of Radiology, to investigate how the specific "clear cell" change occurs, a patient's underlying disease and choice of chemotherapy, and the prognosis for future patients of this rare cancer.
The patient was a 56-year-old Japanese man with a 3-year histry of hepatitis B virus (HBV) infection. The follow-up echo revealed a tumor of the liver. CT and MRI suggested hepatocellular carcinoma (HCC); a cancer of liver cells. The patient had surgery and the tumor was diagnosed as the rare "clear cell ICC", not a conventional HCC.
Unlike reported cases, this patient had HBV infection as the underlying disease. The cell of conventional ICC is usually small and its nucleus occupies a large part of the cell. Clear cell ICC consists of larger cells with copious cytoplasm possibly caused by mucin, lipid, glycogen or by another unknown reason. Therefore the cells look clear. The cancer cells originating from bile ducts often produce much mucin, however the clear cells in this case did not contain mucin, and had a little glycogen.
The literature review disclosed that the risk of metastasis or recurrence is low after the removal of the cancer. There is not enough evidence for the use of any particular treatment including chemotherapy. Therefore, careful follow-up and the acquisition of more case records are important to obtain more evidence on this cancer.
Reference: Toriyama E, Nanashima A, Hayashi H, Abe K, Kinoshita N, Yuge S, Nagayasu T, Uetani M, Hayashi T. A case of intrahepatic clear cell cholangiocarcinoma. World J Gastroenterol 2010; 16(20): 2571-2576
Correspondence to: Tomayoshi Hayashi, MD, PhD, Department
of Pathology, Nagasaki University Hospital, 1-7-1 Sakamoto,
Nagasaki 852-8501, Japan. firstname.lastname@example.org
Telephone: +81-95-8197562 Fax: +81-95-8197564
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World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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