title: Carcinosarcoma of the liver: report of a case.
abstract: A 64-year-old Japanese woman without a history of viral hepatitis was admitted for investigation of a huge liver mass. The tumor, measuring 14 × 12 × 22 cm, had invaded the diaphragm, right lung, and inferior vena cava. Serum examinations demonstrated high levels of carbohydrate antigen 19-9 (CA19-9), and the Child-Pugh score was A. She underwent right lobectomy of the liver and partial resection of the right diaphragm, right lung, and inferior vena cava. Radio- and chemotherapy were also given, but she died of recurrence 3 months after surgery. Microscopically, the tumor exhibited intermingled adenocarcinomatous and atypical mesenchymal components. The carcinomatous component was positive for cytokeratins 7, 19, and 20, chromogranin A, epithelial membrane antigen, c-KIT, and vimentin. The sarcomatous component was positive for vimentin and c-KIT. A review of 36 cases of hepatic carcinosarcoma revealed the following: chronic hepatitis or cirrhosis in 57 % of the patients; increased serum CA19-9 levels in 30 %; a mean tumor diameter of 10 cm; invasion of the adjacent organs or metastasis to distant organs in 47 %; wide intrahepatic infiltration in 44 %; and 50 % survival of only 5 months. Significant differences were seen according to tumor diameter (diameter >5 cm; p < 0.05), wide intrahepatic infiltration (p < 0.05), and extrahepatic invasion/metastasis (p < 0.01). Neither chemotherapy nor radiotherapy contributed to prognosis, but surgical resection resulted in some improvement (p < 0.05).
authors: Department of Surgery, Ishikiri Seiki Hospital, 18-28 Yayoi-cho, Higashi, Osaka City, Osaka, 579-8026, Japan, takatsugu@msic.med.osaka-cu.ac.jp.
authors: Takatsugu
authors: T
authors: Yamamoto
authors: Yukiko
authors: Y
authors: Kurashima
authors: Kazunori
authors: K
authors: Ohata
authors: Ryoya
authors: R
authors: Hashiba
authors: Shogo
authors: S
authors: Tanaka
authors: Takahiro
authors: T
authors: Uenishi
authors: Koichi
authors: K
authors: Ohno
authors: Takashi
authors: T
authors: Ikebe
authors: Katsuhiko
authors: K
authors: Miyaji
authors: Nobusuke
authors: N
authors: Fukumoto
mesh_terms: D000230:Adenocarcinoma; D001943:Breast Neoplasms; D002296:Carcinosarcoma / Q000473:pathology* / Q000601:surgery*; D017809:Fatal Outcome; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery*; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009378:Neoplasms, Multiple Primary; D011013:Pneumonectomy
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