Cancer Chemotherapy and Pharmacology

, Volume 23, Supplement 1, pp S4–S8 | Cite as

Hepatocellular carcinoma with sarcomatous change: a special reference to the relationship with anticancer therapy

  • Masamichi Kojiro
  • Shigetaka Sugihara
  • Saburo Kakizoe
  • Osamu Nakashima
  • Kazumitsu Kiyomatsu
First International Symposium on Treatment of Liver Cancer Kobe, Japan, 15–16 November 1987 Session 1: Epidemiology and Pathology Hepatocellular Carcinoma, Sarcomatous Appearance, Anti-Cancer Therapy


Among 579 autopsy cases of hepatocellular carcinoma (HCC), 55 cases (9.4%) exhibited a sarcomatous appearance. The incidence of HCC with a sarcomatous appearance has been increasing over the past 17 years. A sarcomatous appearance was found in 20 out of 335 autopsy cases of HCC (5.9%) during the 12 years from 1969 to 1980, and in 35 out of 244 autopsy cases of HCC (14.3%) during the last 6 years, when effective anticancer therapies, such as the one-shot injection of anticancer agents into the hepatic artery (one-shot therapy) and transcatheter arterial embolization (TAE), have become popular. A sarcomatous appearance was found in 20.9% of the cases undergoing anticancer therapy and in 4.2% of the cases not undergoing anticancer therapy. Among the various anticancer therapies, the sarcomatous appearance was most frequent (27.6%) in cases with repeated TAE. Thus, a close relationship between the sarcomatous appearance in HCC and anticancer therapies was suggested. Regarding the development of the sarcomatous appearance, we presume that it may be caused by the pyenotypic change of HCC cells caused by anticancer therapy, or that a number of factors, including anticancer therapy, may accelerate the proliferation of the sarcomatous cells existing in the original tumor as one of the histological components. In order to clarify the true nature of sarcomatous lesions in HCC, further histological and biological studies are required.


Carcinoma Cancer Research Hepatocellular Carcinoma Hepatic Artery Special Reference 
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  1. 1.
    Azzopardi G, Chepick OF, Hartmann WH, et al. (1981) Histological typing of breast tumors. World Health Organization, GenevaGoogle Scholar
  2. 2.
    Battifora H (1976) Spindle cell carcinoma: ultrastructural evidence of squamous origin and collagen production by the tumor cells. Cancer 37: 2275–2282Google Scholar
  3. 3.
    Chang WL, Agha FP, Morgan WS (1983) Primary sarcoma of the liver in adults. Cancer 51: 1510–1517Google Scholar
  4. 4.
    Edmondson EA, Steiner PE (1954) Primary carcinoma of the liver: A study of 100 cases among 48 900 necropsies. Cancer 7: 462–503Google Scholar
  5. 5.
    Isomura T, Arakawa M, Wada T, et al. (1979) Hepatocellular carcinoma with sarcoma-like transformation: a case report. Acta Hepatol Jpn 20: 70–75Google Scholar
  6. 6.
    Jaffe RH (1924) Sarcoma and carcinoma of the liver following cirrhosis. Arch Intern Med 33: 330–342Google Scholar
  7. 7.
    Japan Liver Cancer Study Group (1979) Surgery and followup study of primary liver cancer in Japan, report 4. Acta Hepatol Jpn 20: 433–441Google Scholar
  8. 8.
    Kakizoe S, Kojiro M, Nakashima T (1987) Hepatocellular carcinoma with sarcomatous change. Clinicopathologic and immunohistochemical studies of 14 autopsy cases. Cancer 59: 310–316Google Scholar
  9. 9.
    Kawabata K (1980) Pathomorphologic studies of hepatocellular carcinoma: a study of the lymph node with marked metastasis of hepatocellular carcinoma. Acta Hepatol Jpn 21: 203–215Google Scholar
  10. 10.
    Kreyberg L (1981) Histological typing of lung tumors. World Health Organization, GenevaGoogle Scholar
  11. 11.
    Kuwano H, Sonoda T, Hashimoto T, et al. (1984) Hepatocellular carcinoma with oeteolast-like giant cells. Cancer 54: 837–842Google Scholar
  12. 12.
    Nagamine Y, Sasaki K, Kaku K, et al. (1978) Hepatic sarcoma associated with hepatoma. Acta Pathol Jpn 31: 815–824Google Scholar
  13. 13.
    Nakashima T, Kojiro M (1987) Hepatocellular Carcinoma —an atlas of its pathology. Springer-Verlag International, TokyoGoogle Scholar
  14. 14.
    Nakashima T, Kojiro M, Kawano Y, et al. (1982) Histologic growth pattern of hepatocellular carcinoma: relationship to orcein (hepatitis B surface antigen)-positive cells in cancer tissue. Hum Pathol 16: 536–568Google Scholar
  15. 15.
    Oota K (1977) Histological typing of gastric and oesophageal tumors. World Health Organization, GenevaGoogle Scholar
  16. 16.
    Shibasaki K, Kojima N, Fujita K, et al. (1975) Long-term survived cases of hepatocellular carcinoma and their clinicopathological study: three cases of protracted clinical course. Acta Hepatol Jpn 16: 431–440Google Scholar
  17. 17.
    Tsujimoto M, Aozasa K, Nakajima Y, et al. (1984) Hepatocellular carcinoma with sarcomatous proliferation showing an unusual and wide-spread metastasis. Acta Pathol Jpn 34: 839–845Google Scholar

Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • Masamichi Kojiro
    • 1
  • Shigetaka Sugihara
    • 1
  • Saburo Kakizoe
    • 1
  • Osamu Nakashima
    • 1
  • Kazumitsu Kiyomatsu
    • 1
  1. 1.First Department of PathologyKurume University School of MedicineKurumeJapan

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