The rare co-occurrence of cholangiocarcinoma and chronic eosinophilic leukemia

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Abstract
Introduction. Cholangiocarcinoma (CCA) is a rare and highly aggressive malignancy of the bile ducts with a poor prognosis and a 5-year survival rate of approximately 5%. Chronic eosinophilic leukemia (CEL), characterized by clonal eosinophil proliferation, is a rare hematologic malignancy often progressing to acute leukemia. The simultaneous occurrence of these two malignancies is exceedingly rare, according to available research, this is the first case reported in the literature. Case report. This is the case of a 44-year-old female presenting with fatigue, diagnosed with metastatic CCA following imaging and biopsy. During chemotherapy with gemcitabine and cisplatin, the patient developed unexplained leukocytosis and eosinophilia, leading to a subsequent diagnosis of CEL. Despite aggressive treatment, the patient experienced complications, including cholangitis and renal failure, and succumbed to her illness four months post-diagnosis. Conclusions. This case highlights the rare co-occurrence of CCA and CEL, emphasizing the importance of vigilant monitoring for secondary hematologic malignancies in oncology patients. Early recognition and treatment of concurrent disorders can improve clinical outcomes and inform future research on such rare malignancy combinations. Keywords: cholangiocarcinoma chronic eosinophilic leukemia chemotherapy concurrent malignancies

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