Hepatocellular carcinoma with sarcomatous change. Clinicopathologic and immunohistochemical studies of 14 autopsy cases

Abstract

Among 355 autopsy cases of hepatocellular carcinoma (HCC), 14 cases exhibited sarcomatous appearance (incidence, 3.9%). A clinicopathologic study was performed in these 14 cases, and the immunohistochemical localization of keratin (KRT), vimentin (VMT), albumin (ALB), fibrinogen (FBG) and alpha-fetoprotein (AFP) was also examined using the avidin-biotin complex method. Clinically, the HCCs with sarcomatous appearance were characterized by negative or low serum AFP levels and high incidence of extrahepatic metastasis. Grossly they were of infiltrative, mixed expansive and infiltrative, and pedunculated types. Histologically, the tumor consisted mainly of spindle-shaped cells and partly of multinucleated cells, and showed a sinusoidal growth pattern at the tumor-nontumor boundary. Immunohistochemically, tumor cells in the regions showing sarcomatous appearance were frequently found to be positive to KRT and VMT, whereas the percentage of positivity to ALB, FBG, and AFP were not significantly different from those in ordinary HCC. These results strongly suggest that the lesion showing sarcomatous appearance represents the sarcomatous change of HCC rather than being regarded as the complication of HCC and sarcoma.

Transforming Growth Factor‐α Induces the Differentiation of Sarcomatoid Cholangiocarcinoma Cells

“…18) Sarcomatous change in the liver is considered as a result of dedifferentiation. 19,20) In fact, we found that a small number of these sarcomatoid CC cells showed spontaneous morphologic and phenotypic transformation into a maturer stage in continuous culture. In order to clarify the mechanism of these changes, we examined the response of the sarcomatoid cells to some possible cytokines.…”

p53 mutation is a poor prognostic indicator for survival in patients with hepatocellular carcinoma undergoing surgical tumour ablation

“…The remaining 13 had non-cirrhotic HCC tumours. A further two patients had sarcomatoid transformation of hepatocellular carcinoma (Kakizoe et al, 1987). The study included 14 women and 28 men with a mean age of 54.6 years (range 14-73 years).…”

Hepatocellular carcinoma with sarcomatous change: characteristic findings of two-phased incremental CT

“…In contrast to the relatively high frequency of HCC, the incidence of sarcomatous change involved is relatively low and reportedly 3.9% among 350 HCC cases at autopsy [10]. However, the incidence of HCCSC is apparently increasing, reasons for which include the reported increase frequency of transarterial chemotherapy and/or embolization of HCC [11].…”