Synchronous double cancers of primary hepatocellular carcinoma and intrahepatic cholangiocarcinoma: a case report and review of the literature

Abstract

We report a case of double primary liver cancer comprising hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). A 58-year-old Chinese man without obvious liver cirrhosis was diagnosed with multiple HCC in segment V (SV) and segment VIII (SVIII) of the liver. Preoperative abdominal magnetic resonance imaging revealed two solid masses in SV and SVIII. We performed hepatic resection of both segments. The tumors in SV and SVIII were pathologically diagnosed as HCC and ICC, respectively. Immunohistochemically, the HCC in SV was positive for carcinoembryonic antigen and negative for α-fetoprotein (AFP) and cytokeratin (CK), while the ICC in SVIII was negative for both AFP and CK. These observations confirmed the diagnosis of double primary liver cancer (HCC and ICC). Double primary liver cancer is extremely rare. We herein review previous reports of patients with a histological diagnosis of double primary liver cancer. Based on the findings of this case and the literature review, we speculate that the imaging findings of double primary hepatic cancer conform to the pathologic findings.

A rare case of synchronous double primary hepatocellular carcinoma and intrahepatic cholangiocarcinoma: A case report

“…However, the exact origin of dpHCC-ICC remains unclear. Some published studies suggest that cells destined to become hepatocytes or cholangiocytes can develop into HCC and ICC, respectively [ 9 ]. However, other studies have pointed to activated hepatic progenitor cells (HPCs) as a potential source capable of differentiating into both tumor types.…”

Synchronous double primary tumors of liver (small cell neuroendocrine carcinoma and hepatocellular carcinoma)：A case report

“…In this patient, when the liver masses were discovered, biopsy con rmed the diagnosis of small cell neuroendocrine carcinoma, according to the imaging examination, it was divided into stage , post one cycle of chemotherapy, the mass of lung was smaller, but the liver masses were stable, combined with the previous history of hepatitis, biopsy of another liver segment was performed, the pathology showed hepatocellular carcinoma. The incidence of synchronous double primary liver cancers is very low, there were several reports on synchronous primary liver cancers included intrahepatic cholangiocarcinoma and hepatocellular carcinoma (9)(10)(11), but the occurrence of neuroendocrine carcinoma combined with hepatocellular carcinoma was rare, and with poor prognosis, the median time of overall survival and the median time to recurrence were only 17.88 months and 6 months (8). When simultaneous neoplasms are discovered, systematic therapy should be given according to the tumor with the worst prognosis.…”

Successful treatment of colorectal liver metastasis harboring intrahepatic cholangiocarcinoma

“…Although the coexistence of 2 benign primary liver lesions, or a benign and a malignant one, is not infrequent, the finding of 2 unrelated malignant liver tumors is extremely rare. ICC occasionally coexists with other cancers, such as lymphoma, [5] renal cell carcinoma, [6] hepatocellular carcinoma, [7–9] thyroid cancer, [10] and gastrointestinal stromal tumors. [11] Only 2 reports are available in the literature about colorectal metastases with ICC; however, both diagnoses were delayed.…”