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Kanemitsu E, Takahashi R, Nakanishi S, Sueyoshi S, Kobayashi A, Nishimura T, Nagata H. A case of rapidly progressing sarcomatous intrahepatic cholangiocarcinoma with suddenly appearing lymph node metastasis. Surg Case Rep 2024; 10:9. [PMID: 38185762 PMCID: PMC10772016 DOI: 10.1186/s40792-023-01804-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/26/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND The sarcomatous variant of carcinoma is relatively rare in intrahepatic cholangiocarcinoma (ICC). Sarcomatous ICC (SICC) is associated with a poorer prognosis compared with ICC. SICC is rarely diagnosed before surgery due to non-descriptive findings; it progresses rapidly, resulting in miserable prognosis. Here, we report a case of rapidly progressing SICC that showed a clinically significant tumor growth rate. CASE PRESENTATION A 77-year-old woman who had undergone ileocecal resection for cecal cancer 5 years previously was found to have elevated levels of the tumor marker carbohydrate antigen 19-9. Although an abdominal computed tomography (CT) scan did not detect any liver mass lesions until 3 months before this serum examination, the subsequent CT scan revealed a hypodensity 20 mm mass lesion in the right anterior section. Contrast-enhanced CT and magnetic resonance imaging revealed peripheral enhancement in the arterial-to-equilibrium phase. Fluorodeoxyglucose positron emission tomography revealed uptake in the lesion. None of the imaging modalities showed lymph node swelling or distant metastases. She underwent hepatectomy under the diagnosis of ICC or an atypical metastasis from previous cecal cancer. Although preoperative images showed no suspicious lymph node metastasis 3 weeks prior, the hilar lymph node swelled 3 cm and contained adenocarcinoma. Consequently, the patient underwent right anterior sectionectomy and lymph node dissection of the hepatoduodenal ligament. Histopathological examination revealed that the liver tumor was a poorly differentiated adenocarcinoma with sarcomatous pattern. While the patient received adjuvant gemcitabine and S-1 therapy, lymph node metastasis appeared in the mediastinum 13 months after the surgery. She received gemcitabine + cisplatin + S-1 therapy but died 20 months after surgery. CONCLUSION SICC and lymph node metastasis clinically appeared within 3 months and 3 weeks, respectively. Suspected ICC that rapidly progresses should be considered SICC and treated with early resection. SICC is often missed in clinical diagnosis and has a poor prognosis, even after curative resection. While an alternative strategy involving preoperative biopsy and neoadjuvant therapy may be beneficial, it should be approached with discretion due to the potential risks of tumor progression and peritoneal dissemination.
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Affiliation(s)
- Eisho Kanemitsu
- Department of Surgery, JCHO Yamatokoriyama Hospital, 1-62, Asahi-Cho, Yamatokoriyama, Nara, 639-1013, Japan.
| | - Rei Takahashi
- Graduate School of Pharmaceutical Science, Doshisha Women's College of Liberal Arts, 97-1, Kodo, Kyotanabe, Kyoto, 610-0395, Japan
| | - Setsuko Nakanishi
- Department of Radiology, JCHO Yamatokoriyama Hospital, 1-62, Asahi-Cho, Yamatokoriyama, Nara, 639-1013, Japan
| | - Satoru Sueyoshi
- Department of Radiology, Saiseikai Chuwa Hospital, 323, Abe, Sakurai, Nara, 633-0054, Japan
| | - Atsushi Kobayashi
- Department of Surgery, JCHO Yamatokoriyama Hospital, 1-62, Asahi-Cho, Yamatokoriyama, Nara, 639-1013, Japan
| | - Takao Nishimura
- Department of Surgery, JCHO Yamatokoriyama Hospital, 1-62, Asahi-Cho, Yamatokoriyama, Nara, 639-1013, Japan
| | - Hiromitsu Nagata
- Department of Surgery, JCHO Yamatokoriyama Hospital, 1-62, Asahi-Cho, Yamatokoriyama, Nara, 639-1013, Japan
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Sapuppo E, Brunetti O, Tessitore D, Brandi G, Di Giovanni N, Fadda G, Luchini C, Martini M, Quaresmini D, Russo A, Santarpia M, Scarpa A, Scartozzi M, Tuccari G, Franchina T, Silvestris N. Rare histotypes of epithelial biliary tract tumors: A literature review. Crit Rev Oncol Hematol 2023; 181:103892. [PMID: 36481306 DOI: 10.1016/j.critrevonc.2022.103892] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/21/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Adenocarcinoma represents the most frequent biliary tract cancer. However, other rare histotypes can be found in the biliary tract, such as cholangiolocellular carcinoma, cholangiocarcinoma with ductal plate malformation pattern, adenosquamous carcinoma, mucinous carcinoma, signet ring cell carcinoma, clear cell carcinoma, mucoepidermoid carcinoma, lymphoepithelioma-like carcinoma, and sarcomatous cholangiocarcinoma. These cancer types account for less than 10 % of all the already rare biliary tract tumors. Yet, they represent a relevant issue in everyday clinical practice, given the lack of therapeutic recommendations and the overall scarcity of data, mainly deriving from isolated small center-specific cohorts of patients.The shifts of such histotypes from the most common ones reflect genetic and molecular differences, determine changes in clinical aggressiveness, and suggest a possible variability in sensitivity to the standard treatments of biliary adenocarcinomas. The consistency and degree of these variables are still to be solidly demonstrated and investigated. Therefore, this paper aims to review the current literature concerning very infrequent and rare epithelial biliary tract cancers, focusing our attention on the clinical, molecular, and immunohistochemical features of these tumors.
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Affiliation(s)
- Elena Sapuppo
- Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy
| | - Oronzo Brunetti
- Medical Oncology Unit-IRCCS Istituto Tumori "Giovanni Paolo II" of Bari, 70124 Bari, Italy
| | - Dalila Tessitore
- Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy
| | - Giovanni Brandi
- Haematological and Oncological Institute, Department of Experimental, Diagnostic and Specialty Medicine, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Nicola Di Giovanni
- Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy
| | - Guido Fadda
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Section of Pathology, University of Messina, Messina, Italy
| | - Claudio Luchini
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy; ARC-Net Research Center, University and Hospital Trust of Verona, Verona, Italy
| | - Maurizio Martini
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Section of Pathology, University of Messina, Messina, Italy
| | - Davide Quaresmini
- Medical Oncology Unit-IRCCS Istituto Tumori "Giovanni Paolo II" of Bari, 70124 Bari, Italy
| | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Mariacarmela Santarpia
- Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy
| | - Aldo Scarpa
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy; ARC-Net Research Center, University and Hospital Trust of Verona, Verona, Italy
| | - Mario Scartozzi
- Azienda Ospedaliera Universitaria (AOU) Cagliari, University Hospital and University of Cagliari, Cagliari, Italy
| | - Giovanni Tuccari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Section of Pathology, University of Messina, Messina, Italy
| | - Tindara Franchina
- Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy
| | - Nicola Silvestris
- Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy.
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Ji W, Xing Y, Ma J, Zhao Z, Xu H, Zheng S, Li W, Li X. Primary Liver Sarcomatoid Carcinoma: A Case Series and Literature Review. J Hepatocell Carcinoma 2021; 8:1117-1127. [PMID: 34522692 PMCID: PMC8434859 DOI: 10.2147/jhc.s325182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/25/2021] [Indexed: 12/12/2022] Open
Abstract
Background Primary liver sarcomatoid carcinoma (PLSC) is rare. To improve the understanding of PLSC, cases were described and reviewing the literature. Methods A retrospective analysis was performed on 14 cases of PLSC diagnosed by pathology in Northeastern China from 2010 to 2020. An individual participant data analysis based on reported cases was conducted to determine epidemiological characteristics, clinical characteristics, and prognoses of PLSC. Results A total of 136 cases involved our 14 cases and 122 cases from previous reports. The percentages of sarcomatoid hepatocellular carcinoma, sarcomatoid cholangiolocellular carcinoma, and mixed and unclassified types were 36.8%, 41.9%, 5.9%, and 15.4%, respectively. A total of 95.6% PLSC was found in Asia. There was a lower percentage of hepatitis-infected patients in Japan, when compared with the Republic of Korea (38.5% vs 70.0%, P<0.05). Five cases were initially misdiagnosed as a hepatic abscess by imaging. A total of 36.7% cases had metastases when being diagnosed, and 68.9% cases relapsed during the follow-up. The median disease-free survival and overall survival (OS) were 3 months and 5 months, respectively. Only radical surgery (hazard ratio = 0.308, 95% confidence interval 0.186–0.512, P<0.001) indicated a better OS. Conclusion PLSC was more prevalent in Asia and there were possibilities of misdiagnoses. Surgery is still an effective treatment and can significantly prolong the OS. Only limited strategies for recurrent or advanced PLSC, immunotherapy may be possible treatment.
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Affiliation(s)
- Wei Ji
- Cancer Center, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Yunlong Xing
- Plastic Surgery, China-Japan Union Hospital, Jilin University, Changchun, People's Republic of China
| | - Jinshu Ma
- Department of Pathology, China-Japan Union Hospital, Jilin University, Changchun, People's Republic of China
| | - Zhuo Zhao
- Cardiology Department, The Second Hospital of Jilin University, Changchun, People's Republic of China
| | - Hongqin Xu
- Department of Hepatology, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Shuang Zheng
- Department of Radiology, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Wei Li
- Cancer Center, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Xu Li
- Department of Hepatology, The First Hospital of Jilin University, Changchun, People's Republic of China
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Wang Y, Ming JL, Ren XY, Qiu L, Zhou LJ, Yang SD, Fang XM. Sarcomatoid intrahepatic cholangiocarcinoma mimicking liver abscess: A case report. World J Clin Cases 2020; 8:208-216. [PMID: 31970189 PMCID: PMC6962087 DOI: 10.12998/wjcc.v8.i1.208] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/26/2019] [Accepted: 11/30/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Sarcomatoid intrahepatic cholangiocarcinoma (SICC) is an extremely rare and highly invasive malignant tumor of the liver. To our knowledge, the imaging findings of sarcomatous cholangiocarcinoma have been rarely reported; and radiological features of this tumor mimicking liver abscess have not yet been reported.
CASE SUMMARY We present a case of SICC mimicking liver abscess. The patient, a 43-year-old male, complained of repeated upper right abdominal discomfort and intermittent distension over a period of one month. Radiology examination revealed a huge focal lesion in the right liver. The lesion was hypointense on computed tomography with honeycomb enhancement surrounded by enhanced peripheral areas. It showed a hypo-signal on non-contrast T1-weighted images and a hyper-signal on non-contrast T2-weighted images. Radiologists diagnosed the lesion as an atypical liver abscess. The patient underwent a hepatectomy. After surgery, he survived another 2.5 mo before passing away. A search of PubMed and Google revealed 43 non-repeated cases of SICC reported in 20 published studies. The following is a short review in order to improve the diagnostic and therapeutic skills in cases of SICC.
CONCLUSION This report presents the clinical and radiological features of SICC and imaging features which showed hypovascularity and progressive enhancement. SICC can present as a multilocular cyst on radiological images and it is necessary to distinguish this lesion from an atypical abscess. Simple surgical treatment is not the best treatment option for this disease.
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Affiliation(s)
- Yan Wang
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Jia-Lei Ming
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Xing-Yu Ren
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Lu Qiu
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Li-Juan Zhou
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Shu-Dong Yang
- Department of Pathology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Xiang-Ming Fang
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
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Ono K, Hamaoka M, Egi H, Kobayashi T, Tahara H, Kuroda S, Shimizu S, Mukai S, Kochi M, Shiroma N, Arihiro K, Ohdan H. Successful Resection of Solitary Abdominal Wall Metastasis of Sarcomatous Intrahepatic Cholangiocarcinoma. Case Rep Gastroenterol 2019; 13:66-72. [PMID: 31182943 PMCID: PMC6547282 DOI: 10.1159/000496917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 01/11/2019] [Indexed: 11/19/2022] Open
Abstract
Sarcomatous intrahepatic cholangiocarcinoma (ICC) is a rare histological variant of ICC that is composed of both adenocarcinoma (ICC component) and sarcomatous components. Surgery is believed to be the primary treatment, and some reports describe primary resection. However, due to the aggressive malignancy of sarcomatous ICC, there is no report regarding resection of a metastatic lesion. In this report, we present the case of a 75-year-old woman admitted to our hospital with the chief complaint of weight loss. Various imaging techniques demonstrated a single mass in the liver and cecum. A cecal gastrointestinal stromal tumor accompanied by liver metastasis was suspected, and ileocecal resection was performed for diagnostic purposes. However, the tumor was present in the abdominal wall rather than in the cecum. The tumor was resected and diagnosed as undifferentiated sarcoma. We suspected the liver tumor was a series of lesions, so we performed hepatectomy. As the tumor was composed of both adenocarcinoma and sarcomatous components, it was diagnosed as sarcomatous ICC. The histological findings of the abdominal wall tumor were similar to those of sarcomatous ICC, so we diagnosed the abdominal wall tumor as a solitary metastasis of sarcomatous ICC. In this case, solitary metastasis was observed, and we were able to resect both the primary and metastatic lesions. This case illustrates that when solitary metastasis can be seen in sarcomatous ICC, radical resection is possible.
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Affiliation(s)
- Kosuke Ono
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Michinori Hamaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Egi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Seiichi Shimizu
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shoichiro Mukai
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masatoshi Kochi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Noriyuki Shiroma
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Koji Arihiro
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
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Kim DK, Kim BR, Jeong JS, Baek YH. Analysis of intrahepatic sarcomatoid cholangiocarcinoma: Experience from 11 cases within 17 years. World J Gastroenterol 2019; 25:608-621. [PMID: 30774275 PMCID: PMC6371010 DOI: 10.3748/wjg.v25.i5.608] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/03/2019] [Accepted: 01/15/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Intrahepatic sarcomatoid chonalgiocarcinoma (s-CCC) is an extremely rare disease, accounting for less than 1% of hepatobiliary system malignancies, and its pathophysiology is not well known. On the hypothesis that its clinical, serologic, or radiologic diagnosis are not fully understood and its prognosis is poor, we investigated the distinguishing features of s-CCC compared with those of intrahepatic bile duct adenocarcinoma [cholangiocellular carcinoma (CCC)] in patients from a single center.
AIM To analyze the clinical, serologic, imaging, and histopathologic characteristics of intrahepatic s-CCC patients diagnosed in a single center.
METHODS The clinical, serologic, imaging, and histopathologic features of 227 patients diagnosed with intrahepatic cholangiocarcinoma (IHCC) in a single medical center during the last 17 years were analyzed. The characteristics of 11 patients with s-CCC were compared with those of 216 patients with CCC.
RESULTS The number of patients with s-CCC who presented fever and abdominal pain and past history of chronic viral hepatitis or liver cirrhosis (LC) was higher than that of patients with CCC. In imaging studies, patients with s-CCC showed relatively aggressive features. However, no clear distinction was observed between s-CCC and CCC based on other clinical, serologic or radiologic examination results. An accurate diagnosis could be made only via a histopathologic examination through immunohistochemical staining. The clinical course of s-CCC was generally aggressive, and patients had a relatively poor prognosis.
CONCLUSION In patients with s-CCC, early diagnosis through biopsy and aggressive treatment, including surgical resection, are important.
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Affiliation(s)
- Dong Kyun Kim
- Department of Internal Medicine, Dong-A University College of Medicine, Busan 49201, South Korea
| | - Bo Ra Kim
- Department of Radiology, Dong-A University College of Medicine, Busan 49201, South Korea
| | - Jin Sook Jeong
- Department of Pathology, Dong-A University College of Medicine, Busan 49201, South Korea
| | - Yang Hyun Baek
- Department of Internal Medicine, Dong-A University College of Medicine, Busan 49201, South Korea
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Shi D, Ma L, Zhao D, Chang J, Shao C, Qi S, Chen F, Li Y, Wang X, Zhang Y, Zhao J, Li H. Imaging and clinical features of primary hepatic sarcomatous carcinoma. Cancer Imaging 2018; 18:36. [PMID: 30314525 PMCID: PMC6186076 DOI: 10.1186/s40644-018-0171-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/02/2018] [Indexed: 12/13/2022] Open
Abstract
Background Primary hepatic sarcomatous carcinoma (PHSC) is a rare malignancy composed of both carcinomatous (either hepatocellular or cholangiocellular) and sarcomatous components. The purpose of our study was to evaluate the imaging and clinical findings of PHSCs, improving the understanding and diagnosis of tumors. Methods We retrospectively reviewed the imaging and clinical findings of ten patients with pathologically proven PHSCs, including two cases of sarcomatous intrahepatic cholangiocarcinoma (S-ICC), seven cases of sarcomatous hepatocellular carcinoma (S-HCC) and one case of sarcomatous combined hepatocellular and cholangiocarcinoma (S-HCC–CC). Six patients underwent computed tomography (CT) scans and five underwent magnetic resonance imaging (MRI) scans with one of them having both CT and MRI scans. Results Eight of ten patients had a background of chronic hepatitis or cirrhosis. The elevation of alpha-fetoprotein (AFP) was positive in half of the patients. All the tumors were located near the liver subcapsular area and six of ten cases were massive with round or oval shapes and ill-defined. The lesion textures were mainly heterogeneous in eight tumors for the necrosis or hemorrhage. Eight tumors showed hypo-enhancement and nine tumors exhibited initial peripheral rim (five cases) or heterogeneous (four cases) enhancement, followed by progressive (six cases) and peripheral or partial washout (three cases) on the later phases. Of the seven surgically resected tumors, five showed liver capsular invasion with one of them rupturing into the perihepatic space. Vascular thrombosis (five cases), intrahepatic metastasis (four cases), adjacent organ invasion or seeding (three cases), and lymph node metastasis (four cases) were found on imaging or in pathology. The follow-up period ranged from one to 36 months. Four patients with T3-T4 staging died from recurrence and metastasis between 2 and 5 months, and three patients with T1 staging did not have any recurrence between 16 and 24 months. Conclusion PHSC generally presents as a subcapsular mass with hypovascularity and may be characterized by rim-like or heterogeneous enhancement on the arterial phase and a progressive dynamic pattern. These tumors usually coincide with chronic hepatitis or cirrhosis and poor prognosis appears to be associated with TNM staging.
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Affiliation(s)
- Dongli Shi
- Department of Diagnostic Radiology, Beijing You'an Hospital, Capital Medical University, No.8, Xi Tou Tiao, Youanmen wai, Fengtai District, Beijing, 100069, China
| | - Liang Ma
- Center of Interventional Oncology and Liver Diseases, Beijing You'an Hospital, Capital Medical University, No.8, Xi Tou Tiao, Youanmen wai, Fengtai District, Beijing, 100069, China
| | - Dawei Zhao
- Department of Diagnostic Radiology, Beijing You'an Hospital, Capital Medical University, No.8, Xi Tou Tiao, Youanmen wai, Fengtai District, Beijing, 100069, China
| | - Jing Chang
- Department of pathology, Beijing You'an Hospital, Capital Medical University, No.8, Xi Tou Tiao, Youanmen wai, Fengtai District, Beijing, 100069, China
| | - Chen Shao
- Department of pathology, Beijing You'an Hospital, Capital Medical University, No.8, Xi Tou Tiao, Youanmen wai, Fengtai District, Beijing, 100069, China
| | - Shi Qi
- Department of Diagnostic Radiology, Beijing You'an Hospital, Capital Medical University, No.8, Xi Tou Tiao, Youanmen wai, Fengtai District, Beijing, 100069, China
| | - Feng Chen
- Department of Diagnostic Radiology, Beijing You'an Hospital, Capital Medical University, No.8, Xi Tou Tiao, Youanmen wai, Fengtai District, Beijing, 100069, China
| | - Yunfang Li
- Department of Diagnostic Radiology, Beijing You'an Hospital, Capital Medical University, No.8, Xi Tou Tiao, Youanmen wai, Fengtai District, Beijing, 100069, China
| | - Xing Wang
- Department of Diagnostic Radiology, Beijing You'an Hospital, Capital Medical University, No.8, Xi Tou Tiao, Youanmen wai, Fengtai District, Beijing, 100069, China
| | - Yanyan Zhang
- Department of Diagnostic Radiology, Beijing You'an Hospital, Capital Medical University, No.8, Xi Tou Tiao, Youanmen wai, Fengtai District, Beijing, 100069, China
| | - Jing Zhao
- Department of Diagnostic Radiology, Beijing You'an Hospital, Capital Medical University, No.8, Xi Tou Tiao, Youanmen wai, Fengtai District, Beijing, 100069, China
| | - Hongjun Li
- Department of Diagnostic Radiology, Beijing You'an Hospital, Capital Medical University, No.8, Xi Tou Tiao, Youanmen wai, Fengtai District, Beijing, 100069, China.
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Sintra S, Costa R, Filipe C, Simão A. Intrahepatic sarcomatoid cholangiocarcinoma. BMJ Case Rep 2018; 2018:bcr-2018-225017. [PMID: 30244221 DOI: 10.1136/bcr-2018-225017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Sarcomatoid carcinoma is a rare tumour composed of intermingled malignant epithelial and mesenchymal cells, and it has been reported in various organs including the liver. Sarcomatoid cholangiocarcinoma (CCC) is an extremely rare liver primary tumour. Here, we report a case of an elderly man who was admitted to our hospital after head trauma. He performed a head CT that diagnosed cerebral metastasis. On abdominal CT, he presented a 10×8×9 cm-sized hypodense liver mass in the VII and VIII segments, with peripheral enhancement. Histological and immunohistochemical examination of the tumour showed a malignant neoplasm with both carcinomatous and sarcomatous components and positive expression of cytokeratin and vimentin antibodies. The patient was diagnosed with intrahepatic sarcomatoid CCC at an advanced stage and died 45 days after the diagnosis. We emphasise the importance of immunohistochemistry which may provide a clue to proper diagnosis.
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Affiliation(s)
- Sara Sintra
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Rui Costa
- Radiology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Carlos Filipe
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Adélia Simão
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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