Hepatocellular-Cholangiocarcinoma: Helical Computed Tomography Findings in 30 Patients

Ebied, Osama M.; Federle, Michael P.; Blachar, Arye; Brancatelli, Giuseppe; Grazioli, Luigi; Cazals–Hatem, Dominique; Dondero, Fédérica; Vilgrain, Valérie

doi:10.1097/00004728-200303000-00003

Cited by 39 publications

(23 citation statements)

References 16 publications

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“…On MRI, HCC, CC and combined tumors are typically moderately hyperintense compared with adjacent liver on T2-weighted imaging, with enhancement patterns similar to those seen by CT [ 11–16 ] . Additional findings seen in each of the three types of primary liver cancers include satellite nodules, biliary ductal dilation, portal or hepatic venous involvement and adenopathy [ 4 , 5 , 11 , 17 ] .…”

Section: Discussionmentioning

confidence: 99%

Rapid progression of combined hepatocellular carcinoma and cholangiocarcinoma

et al. 2011

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Combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CC) is a rare entity comprising 1–14.2% of all primary liver carcinomas. In this report, we present a case of rapid progression of cHCC-CC, a rare tumor in a 77-year-old Caucasian male patient with hepatitis B-induced cirrhosis, moderately elevated alpha fetoprotein, and imaging and pathologic features of a mixed liver tumor. There was no evidence of metastatic disease in the chest, abdomen or pelvis by computed tomography (CT) scan at the time of diagnosis. Needle biopsy of the segment 8 lesion revealed two discrete histologic components to the tumor: well-differentiated HCC and poorly differentiated adenocarcinoma, consistent with intrahepatic CC.The patient rapidly developed metastatic disease after initial local therapy with hepatic arterial chemoembolization and percutaneous cryoablation, dying within 5 months of diagnosis. Radiofrequency ablation, cryoablation and radioembolization with yttrium-90 microspheres remain possible treatment strategies for patients with cHCC-CC unable to undergo surgical resection. The diagnosis and treatment of cHCC-CC can be challenging due to clinical, imaging and histological features that overlap with pure HCC and CC.

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Section: Discussionmentioning

confidence: 99%

Rapid progression of combined hepatocellular carcinoma and cholangiocarcinoma

et al. 2011

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“…The cHCC-CC lesions resembling cholangiocarcinoma, however, enable low attenuation in the arterial phase and low, iso-or high attenuation in the venous phase [11] . Preoperatively cHCC-CC is, however, usually only considered when a liver tumor has CT features of both hepatocellular carcinoma and cholangiocellular carcinoma [12] . In addition, Toh et al [13] reported a hypodense tumor with vague contrast enhancement associated with elevation of α-fetoprotein levels and multiple regional lymphadenopathies as a cHCC-CC.…”

Section: Discussionmentioning

confidence: 99%

Combined hepatocellular and cholangiocellular carcinoma presenting with radiological characteristics of focal nodular hyperplasia

Willekens¹,

Hoorens²,

Geers³

et al. 2009

WJG

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Combined hepatocellular and cholangiocellular carcinoma (cHCC-CC) is a rare tumor type containing unequivocal elements of both hepatocellular carcinoma and cholangiocarcinoma that are intimately mixed. Although these tumors are usually considered to be more related to hepatocellular carcinoma than to cholangiocarcinoma, they sometimes, in contrast to hepatocellular carcinoma, contain a significant amount of fibrous stroma. This might in some cases explain atypical radiological features. We report a case of a cHCC-CC in a 47-year-old female that resembled focal nodular hyperplasia on Magnetic Resonance Imaging. Correlation of imaging and serum levels of α-fetoprotein and CA19.9 can help to make the correct diagnosis preoperatively.

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“…Such imaging patterns have been previously described by Fowler et al [12], who stated that peripheral arterial enhancement was the most common pattern observed in a combined tumor population. Aoki et al [13] and Ebied et al [14] also concluded that a common feature of combined HCC-CC tumors was target-like or reverse target-like enhancement. In this study, however, typical enhancement pattern of either HCC or CC, whichever major component was present in the combined tumor, was also observed.…”

Section: Discussionmentioning

confidence: 99%