Combined hepatocellular carcinoma and cholangiocarcinoma with components of mucinous carcinoma arising in a cirrhotic liver

Morita, Daisaku; Kagata, Yutaka; Ogata, Sho; Tsuda, Hitoshi; Hatsuse, Kazuo; Mochizuki, Hidetaka; Matsubara, Osamu

doi:10.1111/j.1440-1827.2006.01950.x

Cited by 10 publications

(6 citation statements)

References 10 publications

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“…All of these cases were from Japan. [31][32][33][34] All patients had chronic liver diseases, including alcoholic cirrhosis and chronic hepatitis C. The prognosis was relatively dismal, in which the 1-year mortality rate was 50%. However, this should not be overemphasized since the data was limited due to a few reported cases in the literature.…”

Section: Discussionmentioning

confidence: 99%

Pathological aspects of mucinous cholangiocarcinoma: A single‐center experience and systematic review

Laohawetwanit

Klaikaew

2020

Pathology International

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Cholangiocarcinoma is a malignant neoplasm originating from the biliary epithelium. Its incidence is highest in Southeast Asia, especially in Thailand. Mucinous intrahepatic cholangiocarcinoma (mucinous iCCA), characterized by an abundant extracellular mucin pool accounting for at least 50% of total tumor volume, is an extremely rare variant of such malignancy and is notorious for rapid progression and dismal prognosis. We conducted an 11‐year retrospective analysis of resected mucinous iCCAs from our institution with a systematic review on mucinous iCCAs and combined hepatocellular‐mucinous cholangiocarcinoma (cHCC‐mCCA). There were four resected mucinous iCCA specimens at our institution (prevalence = 0.5%). Most of the patients were male. The clinicopathological characteristics were variable. The diagnosis of mucinous iCCAs could not be rendered without pathological evaluation. Either intraductal papillary neoplasm or biliary intraepithelial neoplasia was present in three out of four cases. One patient passed away at 11 months following liver resection. A total of 19 mucinous iCCAs and four cHCC‐mCCAs from previously published literature were analyzed. The 1‐year mortality rate of mucinous iCCAs from our series and published literature is 35%. The present study confirmed that mucinous iCCA is an exceedingly uncommon variant of iCCA. The differential diagnoses include metastatic carcinoma with mucinous component and cHCC‐mCCA.

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Section: Discussionmentioning

confidence: 99%

Pathological aspects of mucinous cholangiocarcinoma: A single‐center experience and systematic review

Laohawetwanit

Klaikaew

2020

Pathology International

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“…Of the 11 previously reported cases of primary MC of the liver, 4 were combined carcinomas with components of hepatocellular carcinoma (HCC) [ 3 , 10 – 12 ]. All of these four cases suggest that HCC components and MC components in combined carcinomas might originate from the same cancer cells.…”

Section: Discussionmentioning

confidence: 99%

Resected primary mucinous cholangiocarcinoma of the liver

et al. 2018

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BackgroundMucinous cholangiocarcinoma (MC) is a very rare variant of intrahepatic cholangiocarcinoma. MC is characterized by rapid growth, widespread metastasis, and poor prognosis. We report a case of resected MC of the liver.Case presentationWe found a 13.6-cm hypovascular tumor in the left hepatic lobe of a 68-year-old man, which we initially diagnosed as a mass-forming intrahepatic cholangiocarcinoma. Left lobe and caudate resection was performed without major intraoperative or postoperative complications. He was discharged home on postoperative day 9 and had no recurrence for 6 months. Pathological examination showed a mucous lobulated tumor with abundant mucus in the cytoplasm and extracellular regions. After differential diagnosis that considered invasive intraductal papillary neoplasm of the bile duct and metastatic liver tumors from the digestive tract, this tumor was diagnosed as a cholangiocarcinoma rare variant: primary mucinous carcinoma of the liver.ConclusionAnalysis of previous reports suggests that primary MC of the liver could be classified into two subtypes: pure MC and combined hepatocellular carcinoma and MC. Notably, the latter has been reported only in patients with chronic liver disease, whereas the former has only been reported in patients with no underlying disease.

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“…Classical trabecular areas composed of moderately to well-differentiated large and eosinophilic cells as seen in ordinary HCC occur, but sometimes the HCC component is of the poorly differentiated small cell type, classification as HCC certainly requiring immunohistochemistry (Kim et al 2004a). The cholangiocarcinoma component can present with all the characteristic histologic features of intrahepatic CC and may show excessive mucin production (Wada et al 1986;Morita et al 2006) or undergo marked squamous cell differentiation/ metaplasia (Tsuneyama et al 2003). Sometimes, the mixed differentiation only reveals itself in metastases.…”

Section: Chcc-c Classical Typementioning

confidence: 99%

“…Sometimes, the mixed differentiation only reveals itself in metastases. For example, one tumor presented as HCC in the primary lesion, while intrahepatic metastases showed the typical features of CHCC-C (Morita et al 2006). CHCC-C often contains so-called transitional areas showing cells morphologically intermediate between HCC and CC cells.…”

Section: Chcc-c Classical Typementioning

confidence: 99%

Combined Hepatocellular-Cholangiocarcinoma

Zimmermann¹

2016

Tumors and Tumor-Like Lesions of the Hepatobiliary Tract

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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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Combined hepatocellular carcinoma and cholangiocarcinoma with components of mucinous carcinoma arising in a cirrhotic liver

Cited by 10 publications

References 10 publications

Pathological aspects of mucinous cholangiocarcinoma: A single‐center experience and systematic review

Pathological aspects of mucinous cholangiocarcinoma: A single‐center experience and systematic review

Resected primary mucinous cholangiocarcinoma of the liver

Combined Hepatocellular-Cholangiocarcinoma

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