title: [Hepatocholangiocarcinoma in young patient with a giant liver tumour].
abstract: BACKGROUND
  Combined hepatocellular-cholangiocarcinoma is a rare primary hepatic tumour, showing both hepatocellular as well as biliary epithelium differentiation. Its diagnosis is often delayed, as it occurs in young patients without comorbidities and with non-specific symptoms. Most cases are confused with other types of cancer, especially fibrolamellar liver cancer, which is more frequent and has similar clinical and radiological features.
  
  
  METHODS
  The case is presented of a 26 year old woman with a giant combined hepatocellular-cholangiocarcinoma with difficulties in its diagnosis and a complicated surgical approach.
  
  
  CONCLUSIONS
  The definitive diagnosis of this disease is defined by the histological demonstration of cholangiolar and hepatocellular differentiation, with surgical treatment always being the best choice, but with lower survival than classic hepatocellular carcinoma and cholangiocarcinoma. In some patients with unfavourable prognostic factors, adjuvant chemotherapy mainly directed cholangiolar component can be given.
  
  
  CONCLUSIONS
  The current incidence of combined hepatocellular-cholangiocarcinoma varies from 2 to 5% of cases, and is one of the rarest histological types in the world. The large size and hypervascularisation of the tumour makes a surgical approach difficult in these patients, while the rare histological features require a more detailed study of the piece and the application of immunohistochemical techniques to confirm the diagnosis.
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España. Electronic address: anath15@hotmail.com.
authors.forename: Ana Alicia
authors.initials: AA
authors.lastname: Tejera-Hernández
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España.
authors.forename: Mercedes Elisa
authors.initials: ME
authors.lastname: Cabrera-García
authors.affiliation: Servicio de Anatomía Patológica, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España.
authors.forename: María Soledad
authors.initials: MS
authors.lastname: Martínez-Martin
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España.
authors.forename: Gabriel
authors.initials: G
authors.lastname: García-Plaza
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Larrea-Olea
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España.
authors.forename: Juan Ramón
authors.initials: JR
authors.lastname: Hernández-Hernández
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002454:Cell Differentiation; D018281:Cholangiocarcinoma / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D009389:Neovascularization, Pathologic / Q000473:pathology; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor
keywords: Cholangiocarcinoma; Colangiocarcinoma; Hepatocarcinoma; Hepatocholangiocarcinoma; Hepatocolangiocarcinoma; Liver tumour; Tumoración hepática