| Abstract: | Our report detailes an eldly woman with multiple liver space-occupying lesions (SOLs). Abdominal ultrasonography revealed multiple hypoechoic masses of different sizes, and enhanced computed tomography showed multiple nodules and masses in the liver parenchyma. Ultrasound-guided liver biopsy was performed because the radiological and endoscopic examinations could not determine the diagnosis. Pathological diagnosis indicated poorly differentiated adenocarcinoma. Immunohistochemical staining showed that the expression of CK7, CK8/18, CK19, mammaglobin, ER/SP1, PR/1E2 and GS were positive whereas the expression of Hepatocyte, AFP, GPC-3, WT-1, CK20, CD34, Syn, CgA, CD56, TTF-1, NapsinA, CDX-2, GCDFP 15 and CA125 were negative. Combined with pathological and immunohistochemical results, the diagnosis was determined as the primary intrahepatic bile duct adenocarcinoma. However, no definite risk factor had been found for this patient, and we found that the patient had a medical history of fatty liver for 20 years. She was obese, with a body weight of 92 kilograms (BMI, 32.86 Kg/m2), and radiological examinations showed the typical imaging characteristics for fatty liver. According to our current knowledge, we deduce that nonalcoholic fatty liver disease may be the possible risk factor for this patient with intrahepatic bile duct adenocarcinoma, but a mere coincidence cannot be ruled out. In this report, we detail the case and discuss the relationship between nonalcoholic fatty liver disease and primary intrahepatic bile duct adenocarcinoma. |
