The separate-lesion type combined hepatocellular carcinoma and cholangiocarcinoma.
The separate-lesion type of combined hepatocellular carcinoma and cholangiocarcinoma is particularly rare. We treated two such patients with hepatic resection after performing dynamic computed tomography. In case 1, a 64-year-old Japanese man with chronic hepatitis C underwent right hepatic lobectomy for two hepatic tumors; both tumors originally were thought to be hepatocellular carcinomas because both were hypervascular. However, histologic examination revealed that one tumor was hepatocellular carcinoma and another tumor was tubular adenocarcinoma. In case 2, a 73-year-old man, a second lesion was detected 8 months after transcatheter arterial embolization for hepatocellular carcinoma associated with chronic hepatitis C. The newer lesion in case 2 showed delayed enhancement by dynamic computed tomography. We diagnosed the lesion as cholangiocarcinoma and performed right hepatic lobectomy and dissection of lymph nodes in the hepatoduodenal ligament. Histologic examination confirmed that the new lesion was tubular adenocarcinoma. Case 1 and 2 respectively represent synchronous and metachronous occurrence of the separate-lesion variety of combined hepatic cancer.
Hirohashi
Kazuhiro
K
Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan. m2664791@msic.med.osaka-cu.ac.jp
Uenishi
Takahiro
T
Kubo
Shoji
S
Yamamoto
Takatsugu
T
Tanaka
Hiromu
H
Shuto
Taichi
T
Kinoshita
Hiroaki
H
D000368:Aged; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed