Rare primary hepatic carcinosarcoma composed of hepatocellular carcinoma, cholangiocarcinoma, and sarcoma: a case report

Abstract

Primary hepatic carcinosarcoma (HCS) is an extremely rare malignant tumor of the liver that contains carcinomatous and sarcomatous components. The diagnosis, treatment, and prognosis of HCS pose great challenges to clinicians. Herein, we present a case of HCS in a 67-year-old man with unique pathological manifestation. Preoperative magnetic resonance imaging showed a malignant lesion in the right liver and a small sub-focus in the left liver. Radical treatment was performed, including excision of the right posterior lobe of the liver, thrombectomy of the right posterior portal vein, and radiofrequency ablation of lesions in the left liver. The specimens were confirmed to be HCS by pathological examinations, which revealed a combination of poorly differentiated hepatocellular carcinoma, moderately differentiated cholangiocellular carcinoma, and spindle cell sarcoma. Transhepatic arterial chemotherapy and embolization was performed after surgery. Unfortunately, pulmonary metastasis occurred 1.5 months later, which meant a poor prognosis. In this report, we discuss the clinicopathological characteristics of this case and factors that affected surgical outcomes, which may add some ideas for the future diagnosis and treatment of HCS patients.

Spontaneous Rupture as the Initial Symptom of Primary Hepatic Carcinosarcoma: A Thorough Case Report with Follow-up Data and Literature Review

“…HCS is an extremely rare malignant tumor due to its composition of mixed carcinomatous and sarcomatous elements. Speci cally, the WHO de nes HCS as a malignant tumor containing a heterogeneous mixture of carcinomatous, either hepatocellular carcinoma (HCC) or cholangiolocellular carcinoma (CCC), and sarcomatous elements [1] . In addition, this tumor is challenging to diagnose clinically; it is also aggressive and has a poor prognosis, which may be associated with a high frequency of early metastasis and advanced stage at diagnosis.…”

“…Primary hepatic carcinosarcoma (HCS) is an extremely rare malignant tumor that is composed of a mixture of carcinomatous and sarcomatous elements [1] . HCS has the characteristics of carcinomas and the manifestations of sarcomas.…”

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

“…The HSC and HS are frequently misdiagnosed due to their complex clinical presentations, varied histology, and exquisite imagining features [9][10] . They are unusual, featured with nonspeci c symptoms, and often present asymptomatic until they have become large, leading to a clinical dilemma.…”