Recurrent hepatocellular carcinoma with osteoclast-like giant cells: a case report

Abstract

Background Hepatocellular carcinoma with osteoclast-like giant cells is very rare and has an extremely poor prognosis. Here, we report a case of hepatocellular carcinoma with osteoclast-like giant cells that had a relatively better prognosis. Case presentation A 70-year-old Japanese man with hepatitis B virus-related liver cirrhosis was admitted to our hospital for the treatment of recurrent hepatocellular carcinoma. At the age of 60 years, he was first diagnosed as having hepatocellular carcinoma in the right lobe (9 cm in diameter), and liver resection of segment 7/8 was performed. Histological findings showed well-differentiated hepatocellular carcinoma. Since then, imaging studies have been performed every 3 or 4 months. One year later, hepatocellular carcinoma recurred in the lateral segment, and radiofrequency ablation was performed. Nine years after the first presentation, hepatocellular carcinoma recurrences were detected in the caudate lobe and segment 5 by imaging studies. Surgical resection of the caudate lobe was performed, and ultrasonography-guided radiofrequency ablation was subsequently performed for the segment 5 tumor. The resected tumor was simple nodular, well-differentiated HCC; it measured 21 × 21 mm and contained many osteoclast-like giant cells. As neither vascular nor bile duct invasion was found, we believe that radical resection was achieved. Since then, the hepatocellular carcinoma has not recurred for over a year and a half. Conclusion Hepatocellular carcinoma with osteoclast-like giant cells is very rare and the prognosis is extremely poor, but early detection can lead to a better clinical course.

Undifferentiated carcinoma of the liver with osteoclast-like giant cells: a case report and literature review

“…Hepatocellular carcinoma (HCC) with osteoclastlike giant cells (OGCs) is extremely rare and was first described and reported by Munoz [19]. To date, including our case, there have been only 20 reported cases [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. Westra et al [24] reported a liver consultation case without detailed patient information.…”

“…Westra et al [ 24 ] reported a liver consultation case without detailed patient information. Tsukimoto et al [ 35 ] reported a case of HCC recurrence with OGCs, while the remaining cases were primary liver cases. One case was a postmortem examination [ 28 ].…”

“…Clinical and pathological information, such as gender, age, tumor size, clinical presentation, neoadjuvant therapy, underlying liver disease, location of surgery, histopathological diagnosis, cirrhosis, CD68 expression in OGCs, and clinical outcomes were collected for each patient. Detailed clinical and pathological information for these cases, including our case, is presented in Additional file 1: Table S1 [ [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37].…”

“…Without understanding its clinicopathological characteristics, there is a risk of misdiagnosis and delayed diagnosis, resulting in poor prognosis. Since Munoz et al first described this phenomenon in 1980 [19], only 19 similar cases have been reported [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37], and the follow-up information for these cases suggests aggressive biological behavior. Here, we report a rare case of undifferentiated carcinoma of the liver with OGCs and review similar liver cases published between 1980 and 2023.…”