Colangiocarcinoma y hepatocolangiocarcinoma combinado en pacientes con cirrosis

Abstract

Cholangiocarcinoma and combined hepatocellular-cholangiocarcinoma in cirrhotic patientsBackground: Cholangiocarcinoma (CCA) is a primary hepatic tumor, frequently found in patients with liver cirrhosis and biliary tract diseases. Its varieties include isolated CCA or "combined hepatocellular-cholangiocarcinoma" (cHCC-CCA). The latter is uncommon, with poorly defined diagnostic criteria and natural history. Aim: To characterize patients with cirrhosis with a pathological diagnosis of CCA and cHCC-CCA. Material and Methods: Forty-nine liver biopsies with a pathological diagnosis of CCA were reviewed. The clinical records of patients were reviewed to fetch demographic variables, etiology of cirrhosis and clinical presentation. Results: Eight of the 49 patients had cirrhosis (16% of CCA biopsies reviewed). Their median age was 64 (27-71) years and five were females. Four patients had CCA, three patients cHCC-CCA and one had a bifocal tumor. Patients in the CCA group were more commonly symptomatic. Alpha-fetoprotein and CA 19-9 levels were elevated in one of eight and four of six patients, respectively. Within 12 months from diagnosis, five of eight patients died. Conclusions: In most of these cases, the diagnosis of cHCC-CCA and CCA was made in the liver explant study without previous imaging diagnosis. This reinforces the usefulness of the histological study, in specific cases, prior to liver transplantation and emphasizes the importance of systematic explant exploration in these cases.

Associação do etilismo com o desenvolvimento do Câncer Hepático

“…Não obstante, possui uma variação mista, o Hepatocolangiocarcinoma tumoral (cHCC-CCA), que compartilha tanto características de iCCA como de HCC, deriva-se de células progenitoras hepáticas com potencial de diferenciação tanto hepato quanto colangiocelular, representando 1-2% de todos cânceres de hepáticos. (Salinas, 2022) Brazilian Journal of Development, Curitiba, v.9, n.8, p. 24336-24349, aug., 2023 A priori, por mais que seja uma neoplasia rara, apresenta-se mais comumente em homens orientais de meia-idade, sendo hepatolitíase, cirrose, infestação por trematódeos e hepatites virais B e C os fatores de risco. Além disso, pode ter origem em diferentes locais, como já citado anteriormente, podendo apresentar-se em qualquer ponto da via biliar extra ou intra-hepática, sendo esta última mais frequente no lobo hepático esquerdo.…”