Treating unresectable intrahepatic cholangiocarcinoma with transarterial chemoembolization and an unusual progression with cardiac involvement

Abstract

Intrahepatic cholangiocarcinoma is a rare type of cancer that is usually discovered at an advanced stage where surgical treatment is not an option. When compared to standard systemic therapy, transarterial chemoembolization (TACE) can provide a survival benefit to unresectable patients. Extrahepatic tumor spread is not rare, but cardiac involvement is an unusual complication.We present the case of a 56-year-old man with histologically proven intrahepatic cholangiocarcinoma. Oncologic risk factors include hepatitis B and liver cirrhosis. Being in an unresectable stage of the disease, three TACE procedures were performed. Partial response was achieved (according to RECIST) leading to a 16-month survival. However, disease progression was present, with unusual heart metastases.TACE can bring a survival benefit to unresectable cholangiocarcinoma patients. Defining the best disease stages in which TACE can be implemented and introducing it as part of standard treatment guidelines still presents a challenge.