title: Combined hepatocellular carcinoma and cholangiocarcinoma with components of mucinous carcinoma arising in a cirrhotic liver.
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.
authors.affiliation: Department of Pathology II, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Daisaku
authors.initials: D
authors.lastname: Morita
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kagata
authors.forename: Sho
authors.initials: S
authors.lastname: Ogata
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsuda
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hatsuse
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Mochizuki
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsubara
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000378:metabolism / Q000473:pathology*; D001650:Bile Duct Neoplasms / Q000378:metabolism / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic / Q000378:metabolism / Q000473:pathology*; D006528:Carcinoma, Hepatocellular / Q000378:metabolism / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000378:metabolism / Q000473:pathology*; D017809:Fatal Outcome; D006801:Humans; D007150:Immunohistochemistry; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology; D008113:Liver Neoplasms / Q000378:metabolism / Q000473:pathology*; D008297:Male; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000378:metabolism / Q000473:pathology; D014057:Tomography, X-Ray Computed