A retrospective study on the clinical and pathological features of hepatic sarcomatoid carcinoma: Fourteen cases of a rare tumor

Abstract

Hepatic sarcomatoid carcinoma is a rare liver malignancy with atypical clinical symptoms and a high degree of malignancy. To improve the understanding of this disease, we collected the clinical and pathological data of 14 patients with hepatic sarcomatoid carcinoma admitted to the First Affiliated Hospital and Second Affiliated Hospital of Bengbu Medical College from 2011 to 2021 and reviewed the relevant literature.The clinical and pathological data of 14 patients with hepatic sarcomatoid carcinoma were collected from the electronic medical record system of the 2 hospitals. All clinical data were independently reviewed by 2 clinicians, and all pathological data were independently reviewed by 2 pathologists. At the same time, we reviewed the related literature on hepatic sarcomatoid carcinoma in Pubmed and CNKI.This group of 14 patients, 10 males and 4 females, aged 50-77 years. The main symptoms of the patients were abdominal pain, bloating, anorexia, fatigue or weight loss in the upper abdomen, and 3 patients were asymptomatic. On imaging, hepatic sarcomatoid carcinoma manifests as heterogeneous mass with irregular shape and unclear boundary, and computed tomography (CT)/magnetic resonance imaging (MRI) enhanced scan shows progressive or persistent heterogeneous enhancement, marginal enhancement or annular enhancement, and central necrosis. The pathological features of hepatic sarcomatoid carcinoma are the proliferation of spindle cells and pleomorphic cells, which alternate with acinar cells.Hepatic sarcomatoid carcinoma is more common in middle-aged and elderly patients, especially men, and has no characteristic clinical manifestations. Imaging examination and B-ultrasound-guided liver biopsy + immunohistochemistry can help diagnose. Radical surgery is the preferred method for hepatic sarcomatoid carcinoma, and postoperative adjuvant chemotherapy is expected to prolong patient survival.

Ultrasonography, contrast-enhanced ultrasonography and contrast- enhanced computer tomography features of hepatic sarcomatoid carcinoma and hepatic sarcoma: a retrospective study of 23 cases

“…Both HS HSC are rare tumor with high malignancy and poor prognosis [1,5,11] In our study, we did not nd any signi cant difference between the two tumors in the tumor markers, such as AFP, CEA and CA1-99. This is consistent with previous ndings that tumor markers are non-speci c [11,12,14] .Meanwhile, we found signi cant differences between the hepatitis and cirrhotic backgrounds of the two tumor. In our study, 11 patients with HSC had 6 cases of hepatitis (54.5%) and 6 cases of cirrhosis (54.5%), while 12 patients with HS had 0 cases of hepatitis (0%) and 1 case of cirrhosis (8.3%).…”

“…For HS, the imaging presentation is heterogeneous within each kind of HS or between different kinds of HS [31] . Therefore, the diverse pathological classi cation of HS determines its enhancement pattern.…”

“…They are unusual, featured with nonspeci c symptoms, and often present asymptomatic until they have become large, leading to a clinical dilemma. Clinically, asymptomatic, epigastric pain, bloating, anorexia, fatigue and weight loss are main symptoms of these two liver tumors [11][12][13][14] . It has been reported that HSC and HS are initially misdiagnosed as hepatic abscess, HCC, and malignant tumor (MT) by imaging [15][16][17][18] .…”

Surgery after combination therapy with a tyrosine kinase inhibitor and anti-PD-1 antibody in sarcomatoid hepatocellular carcinoma: case report and literature review

“…In this context, certain reports have suggested that infections with hepatitis B/C viruses may contribute to sarcomatoid transformation ( 6 , 13 – 15 ). However, an increasing number of reports on SHC indicate no history of treatment with anticancer or antiviral agents ( 16 , 17 ).…”

“…On the CT/magnetic resonance imaging scan, SHC usually presents as a large mass with an uneven density/signal, peripheral enhancement, central necrosis, variable enhancement of the solid portion with or without the tumor capsule, and intrahepatic metastasis ( 17 , 19 , 20 ). The CT scan in our case showed the mass to be located in the posterior lobe of the liver (right side).…”