title: [A case of sarcomatoid combined hepatocellular-cholangiocarcinoma].
abstract: Combined hepatocellular-cholangiocarcinoma (HCC-CC) with sarcomatoid features is an extremely rare primary liver cancer, of which only four cases have been reported. We report a case of sarcomatoid combined HCC-CC in a 60-year-old woman who complained of right upper quadrant pain and presented with a 7 cm mass in the S4 region of the liver in abdominal CT. Ultrasonography-guided needle biopsy diagnosed it as HCC, and left lobectomy of the liver followed. Microscopically, the tumor consisted of two portions: HCC portion showing trabecular pattern, which had partially sarcomatous area with spindle-shaped tumor cells, and CC portion with glandular pattern. Immunohistochemically, HCC portion reacted positively with alpha-fetoprotein while CC portion demonstrated positive reactivity with carcinoembryonic antigen and mucicarmine. Sarcomatoid cells reacted positively for cytokeratin. She died of tumor recurrence and hepatic failure 12 months after the operation. Combined HCC-CC has poor prognosis, and sarcomatoid HCC has high metastatic potential and poor prognosis compared with ordinary HCC.
authors.affiliation: Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
authors.forename: Bong Ju
authors.initials: BJ
authors.lastname: Jeong
authors.forename: Dong Hyo
authors.initials: DH
authors.lastname: Hyun
authors.forename: Kyoung Wook
authors.initials: KW
authors.lastname: Lee
authors.forename: Sung Tae
authors.initials: ST
authors.lastname: Ryu
authors.forename: Jin-Woo
authors.initials: JW
authors.lastname: Lee
authors.forename: Jung Il
authors.initials: JI
authors.lastname: Lee
authors.forename: Seok
authors.initials: S
authors.lastname: Jeong
authors.forename: Don Hang
authors.initials: DH
authors.lastname: Lee
authors.forename: Pum-Soo
authors.initials: PS
authors.lastname: Kim
authors.forename: Hyung Gil
authors.initials: HG
authors.lastname: Kim
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Jun Mee
authors.initials: JM
authors.lastname: Kim
mesh_terms: D001650:Bile Duct Neoplasms / Q000473:pathology*; D017734:Bile Ducts, Extrahepatic; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000473:pathology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008875:Middle Aged; D012509:Sarcoma / Q000473:pathology*