title: Surgically treated cases of mixed hepatocellular carcinoma and cholangiocarcinoma.
abstract: The mixed type of combined hepatocellular carcinoma and cholangiocarcinoma is particularly rare. Hepatic resection was performed for two patients with mixed hepatocellular carcinoma and cholangiocarcinoma. In case 1, a 55-year-old Japanese man was found to have a hepatic tumor on ultrasonography. Since ultrasonically-guided needle biopsy revealed that the tumor was poorly differentiated hepatocellular carcinoma, the patient underwent a limited hepatic resection. Histologic and immunohistochemical examination revealed that the tumor had elements of both hepatocellular carcinoma and cholangiocarcinoma. Six months after surgery, the patient died of systemic recurrences. In case 2, a 58-year-old man was found by ultrasonography to have a hepatic tumor occupying the entire right hepatic lobe. Computed tomography revealed that the tumor had a portal tumor thrombus. The diagnosis of hepatocellular carcinoma was made because of a markedly elevated serum alpha-fetoprotein concentration, and a right hepatic lobectomy was performed. Histologic and immunohistochemical examination confirmed that the lesion was mixed hepatocellular and cholangiocellular carcinoma. The patient died of multiple recurrent tumors in the remnant liver 3 months after surgery. Surgical control of mixed hepatocellular carcinoma and cholangiocarcinoma is difficult.
authors.affiliation: Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uenishi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hirohashi
authors.forename: Taichi
authors.initials: T
authors.lastname: Shuto
authors.forename: Tadashi
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.forename: Hiromu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kinoshita
mesh_terms: D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D011169:Portal Vein / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography