title: Synchronous double cancers of primary hepatocellular carcinoma and cholangiolocellular carcinoma: a case report.
abstract: Synchronous double cancers consisting of hepatocellular carcinoma (HCC) and cholangiolocellular carcinoma (CoCC) are extremely rare. We herein report a surgical case of synchronous double cancers in a patient with primary HCC and CoCC. A 45-year-old man with hepatitis B was admitted to our hospital with hepatic tumors. The level of protein induced by vitamin K antagonist (PIVKA-II) was found to be elevated. Computed tomography (CT) revealed a 23-mm tumor with early-phase enhancement and late-phase washout in the 6th segment of the liver, and a 10-mm tumor with slight early-phase enhancement and late-phase washout in the 7th segment of the liver. Magnetic resonance imaging (MRI) revealed that the two tumors in the 6th and 7th segments showed low intensity on T1-weighted images and high intensity on T2-weighted images. Based on those preoperative examinations, the liver tumors were diagnosed as multiple primary hepatocellular carcinomas. The patient underwent a posterior segmentectomy. A histopathological examination revealed that the tumor of the 6th segment of the liver was moderately differentiated HCC, and that the tumor of the 7th segment of the liver was CoCC. The postoperative course was uneventful. However, lymph node recurrence was observed 6 months later and the patient died 20 months after surgery. There are only six reported surgical cases of synchronous double primary liver cancers consisting of HCC and CoCC. We are of the opinion that curative resection may be an effective treatment for double cancer consisting of HCC and CoCC, and that it may provide long-term survival.
authors.affiliation: Department of Surgery, Hyogo College of Medicine, 1-1, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan. ssuzumu@hyo-med.ac.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Suzumura
authors.affiliation: Department of Surgery, Hyogo College of Medicine, 1-1, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Yasukane
authors.initials: Y
authors.lastname: Asano
authors.affiliation: Department of Surgery, Hyogo College of Medicine, 1-1, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Tadamichi
authors.initials: T
authors.lastname: Hirano
authors.affiliation: Department of Surgery, Hyogo College of Medicine, 1-1, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Okada
authors.affiliation: Department of Surgery, Hyogo College of Medicine, 1-1, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Uyama
authors.affiliation: Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Aizawa
authors.affiliation: Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Iijima
authors.affiliation: Department of Pathology, Hyogo College of Medicine, 1-1, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Nakasho
authors.affiliation: Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nishiguchi
authors.affiliation: Department of Surgery, Hyogo College of Medicine, 1-1, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Fujimoto
keywords: Cholangiolocellular carcinoma; Double cancer; Hepatectomy; Hepatocellular carcinoma; Recurrence