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

Hepatic sarcoidosis mimicking cholangiocellular carcinoma: A case report and literature review.
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Miyamoto R, Sano N, Tadano S, Inagawa S, Adachi S, Yamamoto M,


Miyamoto R, Sano N, Tadano S, Inagawa S, Adachi S, Yamamoto M, (click to view)

Miyamoto R, Sano N, Tadano S, Inagawa S, Adachi S, Yamamoto M,

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International journal of surgery case reports 2017 10 2541() 165-168 pii S2210-2612(17)30540-0
Abstract
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.

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