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

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.

Hepatic carcinosarcoma with rhabdomyosarcoma: A case report and review of literature

Objective To analyze the clinical and pathological manifestations of a hepatic carcinosarcoma case with rhabdomyosarcoma components (HCSR).Methods A case of HCSR was observed by macroscopy, microscopy, immunohistochemistry and electron microscopy, along with thorough review of correlated literatures.Results The tumor tends to occur in elder patients without differences on gender. Epigarstric sicknesses, AFP rising in serum, and a mass on the right liver shown in radiography are commonly initial signs. It was composed of both hepatic carcinoma and variously differentiated sarcoma components, with identifiable rhabdomyosarcoma. Immunohistochemistry showed that the hepatic carcinosarcoma was positive of epithelial markers and mesenchymatous component was diffuse positive of Vimentin, and mosaic positive of SDHB, CD117, while rhabdomyosarcoma was positive of muscular markers. Transmission electron microscopy showed the tumor had both epithelial and rhabdomyosarcoma ultra-microstructure.Conclusion HCSR is a very rare type and highly malignant tumor with a dismal prognosis, hardly demonstrating unique clinical manifestations. Diagnosis and differential diagnosis rely on combination of histomorphology, immunohistochemistry and ultra-microstructure observation.

Imaging features of ultrasound and contrast-enhanced ultrasound in primary hepatic carcinosarcoma: three cases report

Primary hepatic carcinosarcoma (PHCS) is a very rare malignant tumor with a poor prognosis. Previous studies in the English-language literature were case reports, focused on the clinical aspects, pathology and pathogenesis. Much is unknownabout the imaging characteristics of PHCS while ultrasound is the first imaging examination for hepatic disease. Contrastenhancedultrasound (CEUS) is a proven method that improves the detection and characterization of focal liver lesions. The purpose of the paper is to present the ultrasonographic and other imaging appearance of three cases of PHCS.