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Zhuo J, Han J, Yang L, Wang Y, Shi G, Yan Z, Yang L, Han R, Huang F, Ban X, Duan X. CT and MRI features of sarcomatoid urothelial carcinoma of the bladder and its differential diagnosis with conventional urothelial carcinoma. Cancer Imaging 2024; 24:102. [PMID: 39095926 PMCID: PMC11295343 DOI: 10.1186/s40644-024-00748-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Sarcomatoid urothelial carcinoma (SUC) is a rare and highly malignant form of bladder cancer with a poor prognosis. Currently, there is limited information on the imaging features of bladder SUC and reliable indicators for distinguishing it from conventional urothelial carcinoma (CUC). The objective of our study was to identify the unique imaging characteristics of bladder SUC and determine factors that aid in its differential diagnosis. MATERIALS AND METHODS This retrospective study enrolled 22 participants with bladder SUC and 61 participants with CUC. The clinical, pathologic, and CT/MRI data from both groups were recorded, and a comparison was conducted using univariate analysis and multinomial logistic regression for distinguishing SUC from CUC. RESULTS The majority of SUCs were located in the trigone of the bladder and exhibited large tumor size, irregular shape, low ADC values, Vesical Imaging-Reporting and Data System (VI-RADS) score ≥ 4, the presence of necrosis, and an invasive nature. Univariate analysis revealed significant differences in terms of tumor location, shape, the maximum long-axis diameter (LAD), the short-axis diameter (SAD), ADC-value, VI-RADS scores, necrosis, extravesical extension (EVE), pelvic peritoneal spread (PPS), and hydronephrosis/ureteral effusion (p < .001 ~ p = .037) between SUCs and CUCs. Multinomial logistic regression found that only SAD (p = .014) and necrosis (p = .003) emerged as independent predictors for differentiating between SUC and CUC. The model based on these two factors achieved an area under curve (AUC) of 0.849 in ROC curve analysis. CONCLUSION Bladder SUC demonstrates several distinct imaging features, including a high incidence of trigone involvement, large tumor size, and obvious invasiveness accompanied by necrosis. A bladder tumor with a large SAD and evidence of necrosis is more likely to be SUC rather than CUC.
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Affiliation(s)
- Jiayi Zhuo
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou, Guangdong, 510120, China
- Department of Radiology, Shenshan Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat- sen University, Shanwei, Guangdong, 516621, China
| | - Jingjing Han
- Department of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou, Guangdong, 510120, China
| | - Lingjie Yang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou, Guangdong, 510120, China
| | - Yu Wang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou, Guangdong, 510120, China
| | - Guangzi Shi
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou, Guangdong, 510120, China
| | - Zhuoheng Yan
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou, Guangdong, 510120, China
| | - Lu Yang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou, Guangdong, 510120, China
| | - Riyu Han
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou, Guangdong, 510120, China
| | - Fengqiong Huang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou, Guangdong, 510120, China
| | - Xiaohua Ban
- Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, 510060, China.
| | - Xiaohui Duan
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou, Guangdong, 510120, China.
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Zhao Q, Ji Z, Chen Y, Wang K, Qiu Y, Tian X, Zhu Y, Qin H, Han H, Yuan H, Dong Y, Wang W. Contrast-enhanced ultrasound features of hepatic sarcomatoid carcinoma different from hepatocellular carcinoma. Clin Hemorheol Microcirc 2024; 87:55-65. [PMID: 38160348 DOI: 10.3233/ch-231944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Hepatic sarcomatoid carcinoma (HSC) is a rare malignancy of the liver. The ultrasound and clinical features of HSC have not been determined. OBJECTIVE To investigate and compare the ultrasound and clinical features of HSC and hepatocellular carcinoma (HCC), and to reveal the valuable features of HSC. METHODS The ultrasound features and clinical data of pathologically proven HSC (n = 37) were compared with HCC (n = 92) in a matching ratio of 1:4 using the propensity score (age, gender and tumor size). RESULTS The HSC patients were more likely to accompany with clinical symptoms and vascular invasion than HCC patients (40.5% vs 17.4%, 24.3% vs 6.5%, P < 0.05). The size of HSCs was significantly larger than that of HCCs (P < 0.05). The proportion of patients with elevated alpha-fetoprotein was significantly lower in HSC (35.1% vs 54.3%, P < 0.05). On gray-scale ultrasound images, the HSCs were more likely to demonstrate as indistinct margin and irregular shape lesions compared to HCCs (78.4% vs 48.8%; 70.3% vs 23.9%, P < 0.05). Under color Doppler flow imaging (CDFI), the blood flow signals were more frequently detected in HSC lesions (75.7% vs 56.5%, P < 0.05). Resistance index (RI) was higher in HSCs than in HCCs [0.78 (0.70,0.82) vs 0.70 (0.62,0.76), P < 0.05]. On contrast-enhanced ultrasound (CEUS), HSCs mainly showed entirety heterogeneous hyper-enhancement (48.6%), entirety homogeneous enhancement (18.9%), peripheral and internal septal enhancement (18.9%). The incidence of non-enhanced areas inside HSC lesions was higher than that inside HCC lesions (56.8% vs 31.5%, P < 0.05). During the portal venous and late phases, most of the lesions revealed hypo-enhancement in both groups, whereas earlier washout was observed in HSCs [43.0 s (30.5,58.0) vs 60.0 s (46.3,100.0), P < 0.05]. CONCLUSIONS CEUS features are useful in preoperative and non-invasive differentiation of hepatic sarcomatoid carcinoma and hepatocellular carcinoma.
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Affiliation(s)
- Qiannan Zhao
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhengbiao Ji
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yanling Chen
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Kun Wang
- Department of Ultrasound, Binzhou Medical University Hospital, Binzhou, China
| | - Yijie Qiu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaofan Tian
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuli Zhu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hong Qin
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hong Han
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Haixia Yuan
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Ultrasound, Zhongshan Hospital, Fudan University (Qingpu Branch), Shanghai, China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wenping Wang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Imaging Medicine, Shanghai, China
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Chen J, Chen W, Qu X, Chen Y. Multi-targeted tyrosine kinase inhibitor reverses resistance to immunotherapy in hepatic sarcomatoid carcinoma. J Cancer Res Clin Oncol 2023; 149:17849-17853. [PMID: 37943357 DOI: 10.1007/s00432-023-05491-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/25/2023] [Indexed: 11/10/2023]
Abstract
Hepatic sarcomatoid carcinoma (HSC) is characterized by its aggressive behavior and poor prognosis. As of now, no universally endorsed standard therapeutic approaches for HSC have been established. Herein, we describe the case of a 60-year-old individual diagnosed with HSC, subsequently presenting with multiple metastases postoperatively. Owing to the pronounced expression of programmed cell death protein 1 (PD-1), the individual was subjected to monotherapy utilizing sintilimab for a duration spanning 12 months. Following this regimen, a synergistic treatment approach comprising both anlotinib and sintilimab was instituted, culminating in an ensuing 11 months of efficacious therapeutic response. Throughout the course of treatment, the patient's quality of life remained satisfactory. This particular therapeutic strategy not merely reinforces the efficacy of PD-1 inhibitors in the realm of HSC management, but more pivotally, suggests that tyrosine kinase inhibitors (TKIs) might counteract resistance to PD-1 antagonists, thus offering a potentially augmented treatment paradigm for HSC.
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Affiliation(s)
- Juan Chen
- Department of Medical Oncology, The First Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, Liaoning, China
| | - Wenjuan Chen
- Department of Medical Oncology, The First Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, Liaoning, China
| | - Xiujuan Qu
- Department of Medical Oncology, The First Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, Liaoning, China.
- Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.
- Liaoning Province Clinical Research Center for Cancer, Shenyang, China.
- Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Ministry of Education, The First Hospital of China Medical University, Shenyang, China.
| | - Ying Chen
- Department of Medical Oncology, The First Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, Liaoning, China.
- Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China.
- Liaoning Province Clinical Research Center for Cancer, Shenyang, China.
- Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Ministry of Education, The First Hospital of China Medical University, Shenyang, China.
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Liang B, Huang T, Kuang SL, Xie GY, Liu TQ, Chen YY. Surgery after combination therapy with a tyrosine kinase inhibitor and anti-PD-1 antibody in sarcomatoid hepatocellular carcinoma: case report and literature review. Front Oncol 2023; 13:1212013. [PMID: 37869099 PMCID: PMC10585252 DOI: 10.3389/fonc.2023.1212013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction Although surgery is the preferred treatment for sarcomatoid hepatocellular carcinoma (SHC), the prognosis remains considerably poor due to early postoperative recurrence and metastasis. Reports on surgery after combined treatment with a tyrosine kinase inhibitor and anti-programmed cell death (PD)-1 antibody are unavailable. Case presentation A 69-year-old male patient with SHC was admitted to our hospital for treatment of a liver tumor that was detected on ultrasonography. Abdominal computed tomography with triple-phase enhancement revealed a lesion in the right hepatic lobe that measured 86.0 mm × 75.0 mm × 71.0 mm. Biopsy revealed a pathological diagnosis of liver sarcoma or sarcomatoid carcinoma. The patient subsequently received transcatheter arterial chemo-embolization, as he did not consent to surgery. More than two months later, he received a combination of lenvatinib with camrelizumab, as computed tomography showed an increase in the lesion size (to 123.0 mm × 90.0 mm × 80.0 mm) and lateral growth posterior to the upper pole of the right kidney. Liver resection was performed after 6 months of systemic therapy; pathological examination confirmed a diagnosis of SHC and showed extensive necrosis of tumor cells. Combined treatment with lenvatinib and camrelizumab was continued for 6 months after surgery. The patient has survived for over 24 months after initial diagnosis and is currently tumor-free. Conclusion Combined systemic therapy with a tyrosine kinase inhibitor and anti-PD-1 antibody may represent a feasible treatment strategy for improving resectability in cases of unresectable SHC. The outcomes with this combination may also be explored in cases of resectable SHC that have a high-risk of recurrence; this may improve the therapeutic effect.
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Affiliation(s)
- Bin Liang
- Department of Hepatobiliary, Pancreatic and Spleen Surgery, Guangxi Academy of Medical Sciences, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Tao Huang
- Department of Hepatobiliary, Pancreatic and Spleen Surgery, Guangxi Academy of Medical Sciences, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Shao-Lei Kuang
- Department of Hepatobiliary, Pancreatic and Spleen Surgery, Guangxi Academy of Medical Sciences, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Guang-Yuan Xie
- Department of Hepatobiliary, Pancreatic and Spleen Surgery, Guangxi Academy of Medical Sciences, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Tian-Qi Liu
- Department of General Surgery, the Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yuan-Yuan Chen
- Department of Hepatobiliary, Pancreatic and Spleen Surgery, Guangxi Academy of Medical Sciences, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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He G, Huang W, Zhou Z, Wu H, Tian Q, Tan L, Li X. Dynamic contrast-enhanced CT and clinical features of sarcomatoid hepatocellular carcinoma. Abdom Radiol (NY) 2023; 48:3091-3100. [PMID: 37428205 PMCID: PMC10480274 DOI: 10.1007/s00261-023-03983-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE To investigate the dynamic contrast-enhanced computed tomography (CECT) features and clinical characteristics of sarcomatoid hepatocellular carcinoma (S-HCC). METHODS We retrospectively reviewed the CECT data and clinical findings of 13 patients (11 male and 2 female, with an average age of 58.6 ± 11.2 years) with pathologically proven S-HCC, including 9 patients with surgical resection and 4 patients with biopsy examination. All patients underwent CECT scans. Two radiologists reviewed and evaluated general features, CECT features and extratumoral features of each lesions based on a consensus. RESULTS Among the thirteen tumors, a mean size of 66.7 mm was observed, ranging in diameter from 30 to 146 mm. Seven of thirteen patients had hepatitis B virus (HBV) infection and an elevation of alpha-fetoprotein (AFP) level. Most of cases located in the right lobe of liver (84.6%, 11/13). Nine of thirteen tumors showed lobulated or wavy contours and infiltrative morphology, while eight tumors presented with unclear margin. The tumor textures were mainly heterogeneous for ischemia or necrosis, with solid components dominantly in all cases. Eight of thirteen tumors exhibited "slow-in and and slow-out" dynamic enhancement pattern in CECT, with a enhancement peak in the portal venous phase. Portal vein or hepatic thrombus, adjacent organs invasion and lymph node metastasis were observed in two patients, respectively. Four of thirteen lesions occurred intrahepatic metastasis and hepatic surface retraction respectively. CONCLUSION S-HCC gengerally seen in elderly male with HBV infection and elevated AFP level. The CT manifestations including: large diameter, frequently hepatic right lobe involvement, lobular or wavy contours, ill-defined margins, infiltrative morphology, obvious heterogeneity and dynamic enhancement pattern of "slow-in and and slow-out" , contributed to the diagnosis of S-HCC. These tumors usually occurred hepatic surface retraction and intrahepatic metastasis.
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Affiliation(s)
- Guangming He
- Department of Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, No.250, Changgang East Road, Haizhu District, Guangzhou, 510399 Guangdong China
| | - Weiqing Huang
- Guangzhou Medical University, Guangzhou, 511495 Guangdong China
| | - Zhimei Zhou
- Department of Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, No.250, Changgang East Road, Haizhu District, Guangzhou, 510399 Guangdong China
| | - Hui Wu
- Department of Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, No.250, Changgang East Road, Haizhu District, Guangzhou, 510399 Guangdong China
| | - Qin Tian
- Department of Pathology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510399 Guangdong China
| | - Lilian Tan
- Department of Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, No.250, Changgang East Road, Haizhu District, Guangzhou, 510399 Guangdong China
| | - Xi Li
- Department of Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, No.250, Changgang East Road, Haizhu District, Guangzhou, 510399 Guangdong China
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Bao Y, Li JX, Zhou P, Tong Y, Wang LZ, Chang DH, Cai WW, Wen L, Liu J, Xiao YD. Identifying Proliferative Hepatocellular Carcinoma at Pretreatment CT: Implications for Therapeutic Outcomes after Transarterial Chemoembolization. Radiology 2023; 308:e230457. [PMID: 37642572 DOI: 10.1148/radiol.230457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Background Hepatocellular carcinomas (HCCs) can be divided into proliferative and nonproliferative types, which may have implications for outcomes after conventional transarterial chemoembolization (cTACE). Biopsy to identify proliferative HCC is not routinely performed before cTACE. Purpose To develop and validate a predictive model for identifying proliferative HCCs using CT imaging features and to compare therapeutic outcomes between predicted proliferative and nonproliferative HCCs after cTACE according to this model. Materials and Methods This retrospective multicenter study included adults with HCC who underwent liver resection or cTACE between August 2013 and December 2020. A CT-based predictive model for identifying proliferative HCCs was developed and externally validated in a cohort that underwent resection. Diagnostic performance was calculated for the model. Thereafter, patients in the cTACE cohort were stratified into groups with predicted proliferative or nonproliferative HCCs according to the model. The primary outcome was overall survival (OS), and the secondary outcomes were tumor response rate and progression-free survival (PFS). These were compared between the two groups with use of the χ2 test and the log-rank test. Results A total of 1194 patients (1021 men; mean age, 54 years ± 12 [SD]; median follow-up time, 29.1 months) were included. The predictive model, named the SMARS score, incorporated lobulated shape, mosaic architecture, α-fetoprotein levels, rim arterial phase hyperenhancement, and satellite lesions. The area under the receiver operating characteristic curve for the SMARS score was 0.83 for the training cohort and 0.80 for the validation cohort. According to the SMARS score, patients with predicted proliferative HCCs (n = 114) had lower tumor response rate (48% vs 71%; P < .001) and worse PFS (6.6 months vs 12.4 months; P < .001) and OS (14.4 months vs 38.7 months; P < .001) than those with nonproliferative HCCs (n = 263). Conclusion The predictive model demonstrated good performance for identifying proliferative HCCs. According to the SMARS score, patients with predicted proliferative HCCs have worse prognosis than those with predicted nonproliferative HCCs after cTACE. © RSNA, 2023 Supplemental material is available for this article.
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Affiliation(s)
- Yan Bao
- From the Departments of Radiology (Y.B., Y.T., J.L., Y.D.X.), Pathology (P.Z.), and Liver Surgery (W.W.C.), the Second Xiangya Hospital of Central South University, No. 139 Middle Renmin Rd, Changsha 410011, China; Department of Interventional Radiology, the Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, China (J.X.L.); Department of Interventional Radiology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China (L.Z.W.); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (D.H.C.); and Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China (L.W.)
| | - Jun-Xiang Li
- From the Departments of Radiology (Y.B., Y.T., J.L., Y.D.X.), Pathology (P.Z.), and Liver Surgery (W.W.C.), the Second Xiangya Hospital of Central South University, No. 139 Middle Renmin Rd, Changsha 410011, China; Department of Interventional Radiology, the Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, China (J.X.L.); Department of Interventional Radiology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China (L.Z.W.); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (D.H.C.); and Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China (L.W.)
| | - Peng Zhou
- From the Departments of Radiology (Y.B., Y.T., J.L., Y.D.X.), Pathology (P.Z.), and Liver Surgery (W.W.C.), the Second Xiangya Hospital of Central South University, No. 139 Middle Renmin Rd, Changsha 410011, China; Department of Interventional Radiology, the Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, China (J.X.L.); Department of Interventional Radiology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China (L.Z.W.); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (D.H.C.); and Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China (L.W.)
| | - Yao Tong
- From the Departments of Radiology (Y.B., Y.T., J.L., Y.D.X.), Pathology (P.Z.), and Liver Surgery (W.W.C.), the Second Xiangya Hospital of Central South University, No. 139 Middle Renmin Rd, Changsha 410011, China; Department of Interventional Radiology, the Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, China (J.X.L.); Department of Interventional Radiology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China (L.Z.W.); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (D.H.C.); and Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China (L.W.)
| | - Li-Zhou Wang
- From the Departments of Radiology (Y.B., Y.T., J.L., Y.D.X.), Pathology (P.Z.), and Liver Surgery (W.W.C.), the Second Xiangya Hospital of Central South University, No. 139 Middle Renmin Rd, Changsha 410011, China; Department of Interventional Radiology, the Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, China (J.X.L.); Department of Interventional Radiology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China (L.Z.W.); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (D.H.C.); and Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China (L.W.)
| | - De-Hua Chang
- From the Departments of Radiology (Y.B., Y.T., J.L., Y.D.X.), Pathology (P.Z.), and Liver Surgery (W.W.C.), the Second Xiangya Hospital of Central South University, No. 139 Middle Renmin Rd, Changsha 410011, China; Department of Interventional Radiology, the Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, China (J.X.L.); Department of Interventional Radiology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China (L.Z.W.); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (D.H.C.); and Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China (L.W.)
| | - Wen-Wu Cai
- From the Departments of Radiology (Y.B., Y.T., J.L., Y.D.X.), Pathology (P.Z.), and Liver Surgery (W.W.C.), the Second Xiangya Hospital of Central South University, No. 139 Middle Renmin Rd, Changsha 410011, China; Department of Interventional Radiology, the Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, China (J.X.L.); Department of Interventional Radiology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China (L.Z.W.); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (D.H.C.); and Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China (L.W.)
| | - Lu Wen
- From the Departments of Radiology (Y.B., Y.T., J.L., Y.D.X.), Pathology (P.Z.), and Liver Surgery (W.W.C.), the Second Xiangya Hospital of Central South University, No. 139 Middle Renmin Rd, Changsha 410011, China; Department of Interventional Radiology, the Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, China (J.X.L.); Department of Interventional Radiology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China (L.Z.W.); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (D.H.C.); and Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China (L.W.)
| | - Jun Liu
- From the Departments of Radiology (Y.B., Y.T., J.L., Y.D.X.), Pathology (P.Z.), and Liver Surgery (W.W.C.), the Second Xiangya Hospital of Central South University, No. 139 Middle Renmin Rd, Changsha 410011, China; Department of Interventional Radiology, the Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, China (J.X.L.); Department of Interventional Radiology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China (L.Z.W.); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (D.H.C.); and Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China (L.W.)
| | - Yu-Dong Xiao
- From the Departments of Radiology (Y.B., Y.T., J.L., Y.D.X.), Pathology (P.Z.), and Liver Surgery (W.W.C.), the Second Xiangya Hospital of Central South University, No. 139 Middle Renmin Rd, Changsha 410011, China; Department of Interventional Radiology, the Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, China (J.X.L.); Department of Interventional Radiology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China (L.Z.W.); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (D.H.C.); and Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China (L.W.)
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Ma S, Li C, Ma Y, Wang X, Zhang D, Lu Z. A retrospective study on the clinical and pathological features of hepatic sarcomatoid carcinoma: Fourteen cases of a rare tumor. Medicine (Baltimore) 2022; 101:e30005. [PMID: 35945746 PMCID: PMC9351887 DOI: 10.1097/md.0000000000030005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Hepatic sarcomatoid carcinoma is a rare liver malignancy with atypical clinical symptoms and a high degree of malignancy. To improve the understanding of this disease, we collected the clinical and pathological data of 14 patients with hepatic sarcomatoid carcinoma admitted to the First Affiliated Hospital and Second Affiliated Hospital of Bengbu Medical College from 2011 to 2021 and reviewed the relevant literature. The clinical and pathological data of 14 patients with hepatic sarcomatoid carcinoma were collected from the electronic medical record system of the 2 hospitals. All clinical data were independently reviewed by 2 clinicians, and all pathological data were independently reviewed by 2 pathologists. At the same time, we reviewed the related literature on hepatic sarcomatoid carcinoma in Pubmed and CNKI. This group of 14 patients, 10 males and 4 females, aged 50-77 years. The main symptoms of the patients were abdominal pain, bloating, anorexia, fatigue or weight loss in the upper abdomen, and 3 patients were asymptomatic. On imaging, hepatic sarcomatoid carcinoma manifests as heterogeneous mass with irregular shape and unclear boundary, and computed tomography (CT)/magnetic resonance imaging (MRI) enhanced scan shows progressive or persistent heterogeneous enhancement, marginal enhancement or annular enhancement, and central necrosis. The pathological features of hepatic sarcomatoid carcinoma are the proliferation of spindle cells and pleomorphic cells, which alternate with acinar cells. Hepatic sarcomatoid carcinoma is more common in middle-aged and elderly patients, especially men, and has no characteristic clinical manifestations. Imaging examination and B-ultrasound-guided liver biopsy + immunohistochemistry can help diagnose. Radical surgery is the preferred method for hepatic sarcomatoid carcinoma, and postoperative adjuvant chemotherapy is expected to prolong patient survival.
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Affiliation(s)
- Shuoshuo Ma
- Department of General Surgery, The First Affiliated Hospital of Bengbu Medical Collage
| | - Chunshuang Li
- Department of Pathology, The First Affiliated Hospital of Bengbu Medical College
| | - Yang Ma
- Department of General Surgery, The First Affiliated Hospital of Bengbu Medical Collage
| | - Xiaolei Wang
- Department of Imaging, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Dengyong Zhang
- Department of General Surgery, The First Affiliated Hospital of Bengbu Medical Collage
| | - Zheng Lu
- Department of General Surgery, The First Affiliated Hospital of Bengbu Medical Collage
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Queiroz MM, Munhoz RR, Masotti C, Souza LM, Lima LGCA, Asprino PF, Begnami MDFS, Camargo AA, Bettoni F. Durable Response to Nivolumab in a Patient With Hepatic Sarcomatoid Carcinoma: Evolutive Characterization of Genomic and Immunohistochemical PD-L1 Expression Findings. JCO Precis Oncol 2022; 6:e2200163. [PMID: 36044716 PMCID: PMC9489170 DOI: 10.1200/po.22.00163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Cibele Masotti
- Molecular Oncology Center, Hospital Sírio-Libanês, São Paulo, SP, Brazil
| | - Larissa M Souza
- Molecular Oncology Center, Hospital Sírio-Libanês, São Paulo, SP, Brazil
| | - Luiz G C A Lima
- Department of Pathology, Hospital Sírio-Libanês, São Paulo, SP, Brazil
| | - Paula F Asprino
- Molecular Oncology Center, Hospital Sírio-Libanês, São Paulo, SP, Brazil
| | | | - Anamaria A Camargo
- Molecular Oncology Center, Hospital Sírio-Libanês, São Paulo, SP, Brazil
| | - Fabiana Bettoni
- Molecular Oncology Center, Hospital Sírio-Libanês, São Paulo, SP, Brazil
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