Primary Combined Hepatocellular-Cholangiocarcinoma: A Case of Underdiagnosed Primary Liver Cancer

Ayas, Mohamad Fekredeen; Affas, Saif; Ayas, Zayd; Chand, Momal; Hadid, Tarik

doi:10.7759/cureus.18224

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…The clinical appearance of cHCC-CCA is analogous to that of HCC and iCCA. In fact, it has usually nonspecific symptoms characterized by fatigue, abdominal pain, weight loss, pruritus, and, in advanced states, jaundice, ascites, acute cholangitis, and hepatomegaly [46]. Additionally, in cHCC-CCA patients, it is possible to find several tumour markers, such as alpha-fetoprotein, carcinoembryonic antigen, and carbohydrate antigen 19.9 [47][48][49].…”

Section: Epidemiology Clinical Features and Risks Factorsmentioning

confidence: 99%

Combined Hepatocellular-Cholangiocarcinoma: What the Multidisciplinary Team Should Know

et al. 2022

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Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare type of primary liver malignancy. Among the risk factors, hepatitis B and hepatitis C virus infections, cirrhosis, and male gender are widely reported. The clinical appearance of cHCC-CCA is similar to that of HCC and iCCA and it is usually silent until advanced states, causing a delay of diagnosis. Diagnosis is mainly based on histology from biopsies or surgical specimens. Correct pre-surgical diagnosis during imaging studies is very problematic and is due to the heterogeneous characteristics of the lesion in imaging, with overlapping features of HCC and CCA. The predominant histological subtype within the lesion establishes the predominant imaging findings. Therefore, in this scenario, the radiological findings characteristic of HCC show an overlap with those of CCA. Since cHCC-CCAs are prevalent in patients at high risk of HCC and there is a risk that these may mimic HCC, it is currently difficult to see a non-invasive diagnosis of HCC. Surgery is the only curative treatment of HCC-CCA. The role of liver transplantation (LT) in the treatment of cHCC-CCA remains controversial, as is the role of ablative or systemic therapies in the treatment of this tumour. These lesions still remain challenging, both in diagnosis and in the treatment phase. Therefore, a pre-treatment imaging diagnosis is essential, as well as the identification of prognostic factors that could stratify the risk of recurrence and the most adequate therapy according to patient characteristics.

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Section: Epidemiology Clinical Features and Risks Factorsmentioning

confidence: 99%

Combined Hepatocellular-Cholangiocarcinoma: What the Multidisciplinary Team Should Know

et al. 2022

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“…But in this case, there is no significant rise in serum IgG4, which is then demonstrated in infrequent patients. Ayas et al, in one of the cases, observed that cholangiocarcinoma is a rare tumor with a poor prognosis and complex treatment, making it an undiagnosed entity [ 11 ]. But, in this case, the issue was identified as soon as he presented with the disease in the hospital, which led to better chances of responding to the provided treatment.…”

Section: Discussionmentioning

confidence: 99%

A Typical Case of an Atypical Disease: Klatskin Tumor

Agrawal¹,

Lamture²,

Totade³

2022

Cureus

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Cholangiocarcinoma is a rare type of cancer disorder. The case report is of a 55-years-old male patient who came to the output patient department (OPD) with complaints of abdominal pain and weight loss for 15 days and later was diagnosed with Klatskin tumor after mandatory investigations. After the approval of the tumor board committee, he is under chemotherapy, to which he is responding positively. Klatskin tumor is a type of cholangiocarcinoma occurring at the convergence of the right and left lobes of hepatic bile ducts, forming the common bile duct. The source of cholangiocarcinoma is idiopathic, and most cholangiocarcinoma is treated with the help of either surgical resection or chemotherapy. Surgical resection is performed in initial cases, but most patients present with the advanced stage of Klatskin tumor. CA-19-9 is a tumor marker that indicates the presence of a Klatskin tumor.

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Primary Combined Hepatocellular-Cholangiocarcinoma: A Case of Underdiagnosed Primary Liver Cancer

Cited by 2 publications

References 13 publications

Combined Hepatocellular-Cholangiocarcinoma: What the Multidisciplinary Team Should Know

Combined Hepatocellular-Cholangiocarcinoma: What the Multidisciplinary Team Should Know

A Typical Case of an Atypical Disease: Klatskin Tumor

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