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Combined hepatocellular and cholangiocarcinoma with sarcomatoid transformation: radiologic–pathologic correlation of a case

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Abstract

A 71-year-old man presented to our hospital with 3-week history of fever in the background of loss of both weight and appetite over the past 3 months. He was found to have a large 10-cm mass in the right lobe of the liver on a triple-phase computed tomographic scan. The tumor showed a distinct fatty component, with areas of arterial enhancement and venous washout suggestive of hepatocellular carcinoma (HCC), another component showing progressive and late enhancement suggestive of cholangiocarcinoma (CC), and a third component showing persistent hypoenhancement relative to the liver parenchyma. He underwent surgical resection. This was histopathologically a biphasic tumor composed of areas showing hepatocytic differentiation, in contiguity with areas showing infiltrative glands set within fibrous stroma in keeping with combined hepatocellular and cholangiocarcinoma (cHCC-CC). A third component of pleomorphic spindle and epithelioid appearance in keeping with sarcomatous transformation was also found intimately related to the CC component. The patient developed extensive thoracic and abdominal metastases 2 months after surgery and died shortly after.

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Author notes

  1. Uei Pua

    Present address: Department of Diagnostic Radiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore

Authors and Affiliations

  1. Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore

    Uei Pua & Su-Chong Low

  2. Department of General Surgery, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore

    Yu-Meng Tan

  3. Department of Pathology, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore

    Kiat-Hon Lim

Authors
  1. Uei Pua
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  2. Su-Chong Low
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  3. Yu-Meng Tan
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  4. Kiat-Hon Lim
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Correspondence to Su-Chong Low.

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Pua, U., Low, SC., Tan, YM. et al. Combined hepatocellular and cholangiocarcinoma with sarcomatoid transformation: radiologic–pathologic correlation of a case. Hepatol Int 3, 587–592 (2009). https://doi.org/10.1007/s12072-009-9150-1

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  • DOI: https://doi.org/10.1007/s12072-009-9150-1

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