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KMID : 0980720080270020125
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Keimyung Medical Journal
2008 Volume.27 No. 2 p.125 ~ p.132
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Clinical and Radio-Pathologic Features of Combined Hepatocellular and Cholangiocarcinoma
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Seo Hye-Jin
Park Kyung-Sik
Ahn Sung-Hoon
Kang Yu-Na
Hwang Jae-Seok
Jang Byoung-Kuk
Chung Woo-Jin
Cho Kwang-Bum
Kang Koo-Jeong
Lee Seok-Guen
Kwon Jung-Hyeok
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Abstract
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Among primary hepatic malignancies, hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) are common, but combined hepatocellular and cholangiocarcinoma (HCC-CC) rare. It is difficult to differentiate each other. The aim of this study to identify clinicopathologic feature of combined HCC-CC. Between January 1999 and July 2007, We reviewd retrospectively clinical and radio-pathologic data of pathologically confirmed 8 patients who initially was diagnosed as combined HCC-CC. Male : Female ratio was 6 : 2 and mean age was 56.2 (43-74) years old. Four patients (50%) were related with liver cirrhosis. According to TNM stage, one patient (12.5%) was stage I. Three (37.5%) and four (50%) patients were stage II and III. respectively. Serum αFP level was elevated in seven patients (87.5%) and CA 19-9 level in five patients (62.5%) were elevated. In five patients (62.5%), serum αFP and CA19-9 level were elevated simultaneously. Five patients were diagnosed as HCC and one patients as CC preoperativelly. According to pathologic findings, all mass had HCC and CC components simultaneously in the masses. Four patients (50%) had vascular invasion, and 2 (25%) and 2 patients (25%) had satellite lesions and capsule invasion. Clinical course and long term prognosis of HCC-CC are usually worse than HCC. So accurate diagnosis of HCC-CC is important for appropriate treatment. If serologic patterns and image findings are not consistent with each other, we must suspect the presence of HCC-CC
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KEYWORD
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combined hepatocellular carcinoma and cholangiocarcinoma
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