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Combined Hepatocellular-Cholangiocarcinoma

ICD-O code 8180/3

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Tumors and Tumor-Like Lesions of the Hepatobiliary Tract

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Abstract

Combined hepatocellular-cholangiocarcinoma (CHCC-C) is defined as a tumor that contains unequivocal, intimately mixed elements of both hepatocellular carcinoma and cholangiocarcinoma, resulting in a biphenotypic histologic picture. CHCC-C should not be confounded with collision tumors or rare hepatic mixed tumors. This is a rare liver malignancy of older individuals, probably accounting for less than 5 % of hepatic malignancies. The neoplasm develops in both non-cirrhotic and cirrhotic livers. Etiologic factors include hepatitis virus infections and alcoholic liver disease.

CHCC-C usually presents as a solitary tumor mass. Similar to hepatocellular carcinoma, the tumor tends to invade the portal vein system and bile ducts. Based on distinct histologic patterns, several types of CHCC-C are distinguished in the WHO classification, including a classical type and a type with stem cell features, the latter further subdivided into at least four subtypes. Rare variants of CHCC-C contain sarcomatoid components, or the HCC component is that of fibrolamellar hepatocellular carcinoma. CHCC-Cs are usually highly aggressive lesions with a high rate of metastatic spread.

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    Arthur Zimmermann

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Zimmermann, A. (2017). Combined Hepatocellular-Cholangiocarcinoma. In: Tumors and Tumor-Like Lesions of the Hepatobiliary Tract. Springer, Cham. https://doi.org/10.1007/978-3-319-26956-6_26

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