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Case Reports
. 2023 Jul 27:15:1205-1211.
doi: 10.2147/IJWH.S408055. eCollection 2023.

Case Report. Diagnostic Challenges: Liver Metastases from Mammary Gland Origin or Cholangiocarcinoma?

George Tocu #  1 , Ioana Teodora Popa  2 , Iuliana Ivan  3 , Lucretia Anghel  4 , Luiza A Nechita  4 , Carmina Liana Musat  5 , Laura Florentina Rebegea #  4 , Dana Tutunaru #  1
Affiliations
Case Reports

Case Report. Diagnostic Challenges: Liver Metastases from Mammary Gland Origin or Cholangiocarcinoma?

George Tocu et al. Int J Womens Health. .

Abstract

Liver metastases are secondary malignant tumor formations due to the dissemination of primary malignant tumors, which are often the first clinical manifestation of mammary cancer. We present the case of a 52-year-old female patient from an urban area who came to the walk-in service at the "Sf. Ap. Andrei" Emergency County Hospital, Galati, for laboratory investigations. These revealed a significant increase in CA 15-3 tumor markers and a slight increase in CA 125 and CA 19-9 markers; however, clinical examination did not reveal tumors in the breast and there were no axillary adenopathies. CT exam revealed a large tumor formation in the hepatic right lobe and, close to it, a smaller one. The mammograph showed millimetric lesions at the level of the left mammary gland and bilateral axillary adenopathies. Subsequently, the patient underwent two liver biopsies in two different hospitals, which produced different histological and immunohistochemical results. PET-CT drew attention to a lung tumor and disclosed a different origin of metastases. In the end, correlating all investigations, the final diagnosis was cholangiocarcinoma with liver metastases and lung tumor with lung and bone metastases.

Keywords: biopsy; breast; immunohistochemistry; markers; tumor.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Bilateral mammography with nodular images in the left breast.
Figure 2
Figure 2
CT scan of thorax-abdomen-pelvis: (A) Hepatic tumor at the portal bifurcation; (B) Liver tumor at maximum diameter.
Figure 3
Figure 3
Bone scan: multiple bone metastases.
Figure 4
Figure 4
PET-CT: (A) overall image; (B) liver tumor.
See this image and copyright information in PMC

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