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Print ISSN: 1792-1074 Online ISSN: 1792-1082
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July-2026 Volume 32 Issue 1

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Case Report

Multidetector computed tomography detection of perineural infiltration around the superior mesenteric artery in intrahepatic cholangiocarcinoma: A case report

  • Authors:
    • Myeong Hun Oh
    • Byeong Gwan Noh
    • Hyung Il Seo
    • Young Mok Park
    • Suk Kim
    • Nam Kyung Lee
    • Seung Baek Hong

  • View Affiliations / Copyright

    Affiliations: Department of Surgery, Biomedical Research Institute and Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Republic of Korea, Department of Radiology, Pusan National University School of Medicine, Yangsan, Gyeongsangnam 50612, Republic of Korea
  • Article Number: 303
    |
    Published online on: May 19, 2026
       https://doi.org/10.3892/ol.2026.15658
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Abstract

Intrahepatic cholangiocarcinoma (IHCC) is the second most common primary liver malignancy after hepatocellular carcinoma and is associated with a poor prognosis. Although surgical resection remains the only potentially curative treatment, the 5‑year survival rate is <30%. Among various prognostic factors, perineural invasion (PNI) is considered noteworthy. Multidetector computed tomography (MDCT) plays a critical role in the diagnosis and staging of IHCC and may aid in the detection of PNI. The current study presents the clinical course and radiological findings of an 82‑year‑old woman with IHCC who showed PNI around the superior mesenteric artery, highlighting the importance of preoperative MDCT evaluation.
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Figure 1

Multidetector CT findings of intrahepatic cholangiocarcinoma with suspected PNI around the SMA. In the contrast enhanced CT exam, (A) a 4.0-cm sized heterogenous enhancing mass (arrow) in liver left lobe was noted. (B) Bile duct dilatation (arrow), adjacent to the mass, was noted. (C) Around the hepatic mass, <1 cm satellite nodule (arrow) was also noted. In addition, extrahepatic soft-tissue lesions (arrow), representing PNI, were noted around (D) the common hepatic chain, (E) the SMA and (F) the first jejunal branch. CT, computed tomography; SMA, superior mesenteric artery; PNI, perineural invasion.

Figure 2

Enlarged (magnified) views focusing on the SMA region. (A and B) Baseline contrast-enhanced computed tomography images demonstrate perivascular soft-tissue encasement around the SMA, raising radiological suspicion for perineural/perivascular extension. (C and D) Corresponding magnetic resonance imaging demonstrates a perivascular soft-tissue lesion around the SMA, supporting radiological suspicion of SMA-related perineural/perivascular involvement. SMA, superior mesenteric artery.

Figure 3

Magnetic resonance cholangiopancreatography and magnetic resonance findings of intrahepatic cholangiocarcinoma with PNI around the SMA. (A) A 4.0-cm mass demonstrated high signal intensity (arrow) on T2WI (arrow), (B) low signal intensity (arrow) on T1WI, (C) heterogenous enhancement (arrow) on the portal venous phase and (D) diffusion restriction (arrow) on diffusion WI. In addition, extrahepatic soft-tissue lesions (arrow), representing PNI, demonstrated diffusion restriction around (E) the SMA and (F) the first jejunal branch. WI, weighted imaging; SMA, superior mesenteric artery; PNI, perineural invasion.

Figure 4

FDG PET/CT images of the SMA. (A and B) Representative FDG PET/CT images focusing on the SMA region. SMA, superior mesenteric artery; FDG PET/CT, 18F-fluorodeoxyglucose positron emission tomography/computed tomography.
View References

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Copy and paste a formatted citation
Spandidos Publications style
Oh MH, Noh BG, Seo HI, Park YM, Kim S, Lee NK and Hong SB: Multidetector computed tomography detection of perineural infiltration around the superior mesenteric artery in intrahepatic cholangiocarcinoma: A case report. Oncol Lett 32: 303, 2026.
APA
Oh, M.H., Noh, B.G., Seo, H.I., Park, Y.M., Kim, S., Lee, N.K., & Hong, S.B. (2026). Multidetector computed tomography detection of perineural infiltration around the superior mesenteric artery in intrahepatic cholangiocarcinoma: A case report. Oncology Letters, 32, 303. https://doi.org/10.3892/ol.2026.15658
MLA
Oh, M. H., Noh, B. G., Seo, H. I., Park, Y. M., Kim, S., Lee, N. K., Hong, S. B."Multidetector computed tomography detection of perineural infiltration around the superior mesenteric artery in intrahepatic cholangiocarcinoma: A case report". Oncology Letters 32.1 (2026): 303.
Chicago
Oh, M. H., Noh, B. G., Seo, H. I., Park, Y. M., Kim, S., Lee, N. K., Hong, S. B."Multidetector computed tomography detection of perineural infiltration around the superior mesenteric artery in intrahepatic cholangiocarcinoma: A case report". Oncology Letters 32, no. 1 (2026): 303. https://doi.org/10.3892/ol.2026.15658
Copy and paste a formatted citation
x
Spandidos Publications style
Oh MH, Noh BG, Seo HI, Park YM, Kim S, Lee NK and Hong SB: Multidetector computed tomography detection of perineural infiltration around the superior mesenteric artery in intrahepatic cholangiocarcinoma: A case report. Oncol Lett 32: 303, 2026.
APA
Oh, M.H., Noh, B.G., Seo, H.I., Park, Y.M., Kim, S., Lee, N.K., & Hong, S.B. (2026). Multidetector computed tomography detection of perineural infiltration around the superior mesenteric artery in intrahepatic cholangiocarcinoma: A case report. Oncology Letters, 32, 303. https://doi.org/10.3892/ol.2026.15658
MLA
Oh, M. H., Noh, B. G., Seo, H. I., Park, Y. M., Kim, S., Lee, N. K., Hong, S. B."Multidetector computed tomography detection of perineural infiltration around the superior mesenteric artery in intrahepatic cholangiocarcinoma: A case report". Oncology Letters 32.1 (2026): 303.
Chicago
Oh, M. H., Noh, B. G., Seo, H. I., Park, Y. M., Kim, S., Lee, N. K., Hong, S. B."Multidetector computed tomography detection of perineural infiltration around the superior mesenteric artery in intrahepatic cholangiocarcinoma: A case report". Oncology Letters 32, no. 1 (2026): 303. https://doi.org/10.3892/ol.2026.15658
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