Clinical Journal of Gastroenterology

, Volume 3, Issue 2, pp 97–103 | Cite as

Hepatic carcinosarcoma with heterogeneous carcinomatous and sarcomatous elements: report of a case and review of the literature

  • Hirofumi Tazawa
  • Toshiyuki Itamoto
  • Akihiko Oshita
  • Tsuyoshi Kobayashi
  • Hironobu Amano
  • Hirotaka Tashiro
  • Hideki Ohdan
  • Shoichi Takahashi
  • Kazuaki Chayama
  • Koji Arihiro
  • Osamu Nakashima
Case Report


We report a rare case of hepatic carcinosarcoma consisting of two carcinomatous components and four sarcomatous components. A 54-year-old Japanese man presented with sudden right upper abdominal pain. Computed tomography showed a hepatic tumor measuring 17 cm in the greatest dimension and intractable ascites, suggesting rupture of hepatocellular carcinoma (HCC). Transcatheter arterial embolization was repeated at our hospital, resulting in stabilization of the patient’s general condition. Right anterior and left median sectionectomies were performed. Histologically, the tumor consisted of carcinomatous and sarcomatous elements. The carcinomatous elements consisted of moderately differentiated HCC (positive for hepatocyte antibody, murine monoclonal anti-cytokeratin antibody, and alpha-fetoprotein and negative for S-100 and desmin) and adenocarcinoma (negative for cytokeratin 7 and positive for carcinoembryonic antigen). Sarcomatous elements consisted of undifferentiated spindle cell sarcoma, rhabdomyosarcoma with acidophil striated cells including striped cells (desmin-positive), chondrosarcoma with cartilage matrix (S-100-positive), and osteosarcoma with osteoid. The sarcomatous elements were negative for epithelial markers. The patient is alive at 34 months after the operation with peritoneal dissemination. A total of 23 cases, including the present case, of hepatic carcinosarcoma have been reported in the English language literature. This is the third reported case of hepatic carcinosarcoma with heterogeneous carcinomatous and sarcomatous elements.


Hepatic carcinosarcoma HCC Rhabdomyosarcoma Chondrosarcoma Osteosarcoma 


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Copyright information

© Springer 2010

Authors and Affiliations

  • Hirofumi Tazawa
    • 1
  • Toshiyuki Itamoto
    • 1
  • Akihiko Oshita
    • 1
  • Tsuyoshi Kobayashi
    • 1
  • Hironobu Amano
    • 1
  • Hirotaka Tashiro
    • 1
  • Hideki Ohdan
    • 1
  • Shoichi Takahashi
    • 2
  • Kazuaki Chayama
    • 2
  • Koji Arihiro
    • 3
  • Osamu Nakashima
    • 4
  1. 1.Second Department of SurgeryHiroshima University School of MedicineHiroshimaJapan
  2. 2.Programs for Biomedical Research, Division of Frontier Medical Science, Department of Medicine and Molecular Science, Graduate School of Biomedical SciencesHiroshima University School of MedicineHiroshimaJapan
  3. 3.Central Clinical Division of Anatomical PathologyHiroshima University School of MedicineHiroshimaJapan
  4. 4.Department of PathologyKurume University School of MedicineKurumeJapan

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