Combined hepatocellular carcinoma and cholangiocarcinoma with components of mucinous carcinoma arising in a cirrhotic liver

Pathol Int. 2006 Apr;56(4):222-6. doi: 10.1111/j.1440-1827.2006.01950.x.

Abstract

A rare autopsy case of combined hepatocellular and cholangiocarcinoma, occurring in a 54-year-old man with liver cirrhosis, is presented. Initial laboratory data included CEA 52.1 ng/mL, DUPAN-2 1600 U/mL, AFP 2 ng/mL, and negativity for hepatitis B surface antigen, hepatitis B early antigen and hepatitis B core antibody. Ultrasonography and CT scan showed a large tumor node in the liver with ringed enhancement, swelling of several para-aortic lymph nodes, and ascites. Clinically, it was not possible to determine whether the hepatic tumor was an intrahepatic cholangiocarcinoma or a metastatic carcinoma. Histologically, the primary lesion was composed solely of hepatocellular carcinoma (HCC) with a trabecular pattern, and the intrahepatic metastases consisted of a variable admixture of HCC and cholangiocarcinoma (CC) with excessive mucin production. Interestingly, the tumor cell cluster showing a trabecular growth pattern produced mucin and had immunohistochemical expression of hepatocyte, cytokeratins 7 and 8. It is concluded that these hepatic tumor cells had both HCC and CC characters.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma, Mucinous / metabolism
  • Adenocarcinoma, Mucinous / pathology*
  • Bile Duct Neoplasms / metabolism
  • Bile Duct Neoplasms / pathology*
  • Bile Ducts, Intrahepatic / metabolism
  • Bile Ducts, Intrahepatic / pathology*
  • Carcinoma, Hepatocellular / metabolism
  • Carcinoma, Hepatocellular / pathology*
  • Cholangiocarcinoma / metabolism
  • Cholangiocarcinoma / pathology*
  • Fatal Outcome
  • Humans
  • Immunohistochemistry
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / pathology
  • Liver Neoplasms / metabolism
  • Liver Neoplasms / pathology*
  • Male
  • Microscopy, Electron, Transmission
  • Middle Aged
  • Neoplasms, Multiple Primary / metabolism
  • Neoplasms, Multiple Primary / pathology
  • Tomography, X-Ray Computed