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Histological heterogeneity in primary and metastatic classic combined hepatocellular-cholangiocarcinoma: a case series

Virchows Archiv volume 471, pages 619–629 (2017)Cite this article

Abstract

Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare and aggressive primary liver cancer with both hepatocellular and cholangiocellular differentiation. Due to its bi-phenotypic component, cHCC-CC is a heterogeneous tumour and histopathological analysis of metastatic deposits is poorly characterized. In this retrospective study, we describe four patients in whom the histology from resected specimens of both primary and recurrent and/or metastatic tumour was available for comparison and immunohistochemical characterization. Our study shows that recurrent or metastatic deposits replicate the heterogeneity of the primary cHCC-CC, that even originally small foci of divergent differentiation can become predominant later on and that hepatocellular and cholangiocellular components can show different tropism in distant organs. In our experience, the behaviour of recurrent/metastatic cHCC-CC is unpredictable and histological examination is necessary to guide treatment options at present.

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Acknowledgements

CDV is supported by the Nuovo-Soldati Cancer Research Foundation.

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Affiliations

  1. King’s College Hospital, Institute of Liver Studies, London, UK

    Claudio De Vito, Nigel Heaton & Alberto Quaglia

  2. Division of Clinical Pathology, Service de Pathologie Clinique, Geneva University Hospital, 1211, Geneva, Switzerland

    Claudio De Vito

  3. Department of Research Oncology, Division of Cancer Studies, King’s College London, London, UK

    Debashis Sarker

  4. Department of Medical Oncology, Guy’s and St Thomas’ Hospital, London, UK

    Debashis Sarker & Paul Ross

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  1. Claudio De Vito
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  2. Debashis Sarker
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  5. Alberto Quaglia
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Correspondence to Claudio De Vito.

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De Vito, C., Sarker, D., Ross, P. et al. Histological heterogeneity in primary and metastatic classic combined hepatocellular-cholangiocarcinoma: a case series. Virchows Arch 471, 619–629 (2017). https://doi.org/10.1007/s00428-017-2196-x

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  • DOI: https://doi.org/10.1007/s00428-017-2196-x

Keywords

  • Combined hepatocellular-cholangiocarcinoma
  • Metastasis
  • Heterogeneity