Repeat hepatectomy for intrahepatic recurrence of cholangiolocellular carcinoma.

A 68-year-old man underwent a partial resection of the liver and lymph node dissection for a tumor, 3.0 cm in diameter, in S4 of the liver under the diagnosis of cholangiocellular carcinoma (CCC). The histological diagnosis was cholangiolocellular carcinoma (CoCC) and lymphatic permeation and venous invasion were recognized. Seven months after surgery, CT demonstrated two recurrent nodules in S7 and S8 of the liver, then a partial resection of the liver was performed. The gross and pathological findings were the same as the previously resected tumor. Four months after the second operation, CT demonstrated dilated intrahepatic bile ducts and lymph node swelling of the hepatic hilum. The patient died of disease thirteen months after the first operation. On the basis of the clinical and pathological features of this case, we consider that CoCC clinically resembles CCC and prognosis may be unfavorable, although it has characteristic pathological findings. It is still controversial whether CoCC should be accepted as a separate entity. The significance of repeat hepatectomy for recurrence and adjuvant chemotherapy should be clarified to improve the prognosis of CoCC.