Primary adenosquamous carcinoma of the liver: case report

Abstract

We describe a case of adenosquamous carcinoma of the liver, including treatment for the recurrence. A 67-year-old man with prolonged high fever was diagnosed with a mass lesion in the left lobe of the liver seen by imaging studies. That mass lesion was histologically diagnosed as cholangiocarcinoma by needle biopsy. Left hepatic lobectomy was performed, and a tumor was found that measured 8.0 x 7.0 x 6.0 cm. It was a yellowish white solid mass without macroscopic invasion of the intrahepatic bile duct. Histological examination of the resected specimen revealed both adenocarcinoma and squamous cell carcinoma. The postoperative course was uneventful, but abdominal computed tomography 3 months after operation revealed seven masses in the remnant liver. We diagnosed recurrence of the tumor, and intrahepatic arterial infusion of cisplatin and 5-fluorouracil was begun. A partial remission resulted. Progression-free survival after chemotherapy lasted 2 months. However, the tumor markers and remnant tumor size increased gradually 9 months after the operation, and he died 14 months after surgery. We also review 41 cases of adenosquamous carcinoma of the liver reported in the Japanese and English language literature, including the present case.

A case of primary adenosquamous carcinoma of the liver

“…An alternative theory suggests that ASC of the liver arises from the squamous metaplasia of adenocarcinoma. 1 , 2 , 8 - 10 From this proposal, if metaplatic squamous epithelium subject to malignant transformation, the tumor tissue may be composed of normal epithelium. However, most tumor tissue is composed of squamous cell carcinoma and adenocarcinoma cells.…”

Adenosquamous carcinoma of the liver

“…According to Takahashi et al,7 squamous cell carcinoma components have DNA aneuploidy patterns and high proliferative activity, so that a squamous cell carcinoma component shows more malignant biological behavior. Suzuki et al8 described the mean survival periods for patients with (n=5) and without (n=23) lymph node dissection were 29.6 and 6.2 months, respectively. All ASC patients surgically resected died of the disease within 4-8 months after surgery and the survival curve of patients with ASC was also significantly worse than that of patients with common cholangiocarcinoma 9.…”

A Clinicopathologic Study of Primary Adenosquamous Carcinoma of the Liver

“…An alternative theory suggests that ASC of the liver arises from the squamous metaplasia of adenocarcinoma. 2,15,[19][20][21] According to this proposal, if metaplastic squamous epithelium does undergo malignant transformation, the tumor tissue may be composed of normal epithelium. However, most tumor tissue is comprised of only squamous cell carcinoma and adenocarcinoma cells.…”

“…2,[5][6][7][8][9][10][11][12][13] Included in this case study is a 52-year-old male patient who consulted our clinic with liver dysfunction. Laboratory data showed an elevation in alkaline phosphatase, g-glutamyl transpeptidase, and tumor markers such as carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9).…”

“…Of the 65 cases selected for review, including our case, clinicopathologic data were obtained for 42 cases [6][7][8][9][10][11][12][13] (Table 1). For all cases, a complete physical examination and clinical history were described in the literature.…”