title: Primary hepatic carcinosarcoma.
abstract: BACKGROUND
  Primary hepatic carcinosarcoma is a rare malignant tumor containing an intimate mixture of carcinomatous and sarcomatous elements. Reports on risk factors, epidemiology, and pathogenesis of the tumor as well as the experience in its treatment are limited.
  
  
  METHODS
  We present a case of primary carcinosarcoma of the liver in a 69-year-old man who complained of right hypochondrial pain and weight loss for two months.
  
  
  RESULTS
  Magnetic resonance imaging revealed a 14 x 12 cm mass in segments 7-8 and 4 of the liver with vena hepatica invasion. An ultrasonography-guided biopsy showed osteoid tissue without osteoblastic rimming. Vascular structures accompanied the osteoid tissue. The patient underwent surgery after a diagnosis of hemangioma. Intraoperative frozen sections revealed a carcinosarcoma associated with an osteosarcoma and cholangiocellular carcinoma components.
  
  
  CONCLUSIONS
  Preoperative diagnosis of this rare primary hepatic malignant tumor may be difficult by biopsy owing to intratumoral heterogeneity. Highly mature areas of the osteosarcomatous component may lead to misdiagnosis of metaplastic bone tissue. Clinicopathologic features of this rare entity are discussed.
authors.affiliation: Department of Gastroenterology, Erciyes University, Medical School, Kayseri, Turkey. drcelikbilek@yahoo.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Celikbilek
authors.forename: Kemal
authors.initials: K
authors.lastname: Deniz
authors.forename: Edip
authors.initials: E
authors.lastname: Torun
authors.forename: Tarik
authors.initials: T
authors.lastname: Artis
authors.forename: Ersin
authors.initials: E
authors.lastname: Ozaslan
authors.forename: Okkes Ibrahim
authors.initials: OI
authors.lastname: Karahan
authors.forename: Tahir Ercan
authors.initials: TE
authors.lastname: Patiroglu
authors.forename: Omer
authors.initials: O
authors.lastname: Ozbakir
mesh_terms: D000368:Aged; D001706:Biopsy; D002296:Carcinosarcoma / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D005629:Frozen Sections; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D012516:Osteosarcoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery