• Xiaofei Cheng, Feng Zhao, Dong Chen, Piao Yang, Weixiang Zhong, Xiangming Xu, and Weilin Wang.
• Department of Colorectal Surgery.
• Medicine (Baltimore). 2018 Dec 1; 97 (51): e13751.

RationaleColorectal liver metastasis develops in 50% of patients diagnosed with colorectal cancer, whereas concurrent intrahepatic cholangiocarcinoma (ICC) and colorectal liver metastases is extremely rare.Patient ConcernsA 72-year-old man was referred to our hospital complaining of abdominal discomfort, diarrhea, and weakness over the last month.DiagnosesColorectal liver metastases concurrent intrahepatic cholangiocarcinoma (ICC).InterventionsThe patient was treated with mFOLFOX6 (5-fluorouracil 2400 mg/m, leucovorin 400 mg/m, and oxaliplatin 85 mg/m) plus bevacizumab 5 mg/kg every 2 weeks for 2 months. However, chemotherapy was not effective for the liver S3 lesion in our case. The possibility of ICC was considered based on the multidisciplinary team (MDT) mode, together with an anomalous increase in cancer antigen 19-9 and a history of hepatolithiasis.OutcomesSimultaneous resection of the colon cancer and liver tumors was performed at 6 weeks after discontinuing bevacizumab. Colorectal liver metastases concurrent ICC was confirmed by postoperative pathology. The patient's disease-free survival time is currently >14 months.LessonsThis is the first case report of the diagnosis and timely treatment of colorectal liver metastases harboring ICC. These results suggest that multiple primary tumors should be considered as a differential diagnosis when imaging or laboratory test results are abnormal.

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