Metastasi muscolo scheletriche: un inusuale sito secondario di colangiocarcinoma intraepatico

Intrahepatic cholangiocarcinoma is a malignant tumor growing in the biliary epithelium and a devastating malignancy that presents late, difficult to diagnose and that often invades adjacent organs or metastasizes to other visceral organs such as lungs, bones, adrenals, and brain. Skeletal muscle is one of the most uncommon sites of metastasis from any malignancy. Although direct muscle invasion by primary malignancy is well recognized, few cases of metastasis to skeletal muscle distant from the primary carcinoma have been published. Primary carcinoma sites to distant skeletal muscle metastasis included the stomach, esophagus, lung, colon, and pancreas. The only case of distant skeletal muscle metastasis of intrahepatic cholangiocarcinoma of our knowledge is that of a 44 years old man with Budd-Chiari Syndrome secondary to intrahepatic cholangiocarcinoma and multiple skeletal muscle metastases in bilateral buttock and erector spinal muscle. We report the case of a 52 years man with cholangiocarcinoma and metastases in right deltoid muscle and orbital invasion.