[Two cases of long-term survival after treatment of recurrent intrahepatic cholangiocarcinoma and intrahepatic metastasis in the remnant liver with repeated hepatectomy].

We report 2 cases of recurrent intrahepatic cholangiocarcinoma (ICC) with intrahepatic metastasis in the remnant liver in patients who underwent repeated hepatectomy and are currently alive and free of the disease. Case 1 involves a 53-year- old woman who underwent extended right hepatectomy for mass-forming type ICC (7-cm in diameter) in the right lobe. After 7 months, she experienced tumor recurrence, and exhibited a 3.8-cm solitary intrahepatic metastasis in the remnant left lateral segment. The patient underwent partial resection of the lateral segment and is currently disease-free at 2 years and 9 months after the recurrence. Case 2 involves a 59-year-old woman who underwent extended left hepatectomy for combined mass-forming and periductal-infiltrating-type ICC( 5-cm in diameter) in the left lobe. After 2 years and 3 months, she experienced tumor recurrence, and exhibited a 3-cm solitary intrahepatic metastasis in the remnant right anterior segment 8. She underwent partial resection of segment 8 and is currently disease-free at 2 years and 11 months after the recurrence. Most of the recurrences of ICC in the remnant liver exhibit multiple lesions or concomitant extrahepatic metastases; therefore, the indication of repeated hepatectomy for intrahepatic recurrence in the remnant liver is restrictive. However, most of the reported cases on repeated hepatectomy for intrahepatic recurrence involved a solitary metastasis in the remnant liver, and revealed a relatively favorable prognosis. Thus, we believe that a solitary recurrence of ICC in the remnant liver could be an indication for repeated hepatectomy.