Semin Liver Dis 2010; 30(1): 107-112
DOI: 10.1055/s-0030-1247137
DIAGNOSTIC PROBLEMS IN HEPATOLOGY

© Thieme Medical Publishers

Hepatocellular Carcinoma and Hepatic Adenocarcinosarcoma in a Patient with Hepatitis B Virus-Related Cirrhosis

Qian Zhao1 , Chang-Qing Su2 , Hui Dong1 , Xin-Yuan Lu1 , Meng-Chao Wu3 , Wen-Ming Cong1
  • 1Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
  • 2Laboratory of Gene and Viral Therapy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
  • 3 Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
Further Information

Publication History

Publication Date:
19 February 2010 (online)

ABSTRACT

The authors present the case of a 48-year-old man with hepatitis B cirrhosis, who developed two primary malignant liver tumors that were morphologically distinct from each other. The first tumor was a hepatocellular carcinoma and the second tumor, detected 17 months later was a hepatic carcinosarcoma with cholangiocarcinomatous and sarcomatous components, without any hepatocellular carcinoma component. Clonality studies using microsatellite-based loss of heterozygosity (LOH) demonstrated different LOH patterns existed between the hepatocellular carcinoma and the hepatic carcinosarcoma, indicative of different clonal origins. The authors discuss the histogenesis, histopathologic diagnosis, and clinical behavior of hepatic carcinosarcoma.

REFERENCES

  • 1 Morimoto O, Nagano H, Sakon M et al.. Diagnosis of intrahepatic metastasis and multicentric carcinogenesis by microsatellite loss of heterozygosity in patients with multiple and recurrent hepatocellular carcinomas.  J Hepatol. 2003;  39(2) 215-221
  • 2 Ng I O, Guan X Y, Poon R T, Fan S T, Lee J M. Determination of the molecular relationship between multiple tumour nodules in hepatocellular carcinoma differentiates multicentric origin from intrahepatic metastasis.  J Pathol. 2003;  199(3) 345-353
  • 3 Inaba K, Suzuki S, Sakaguchi T et al.. Double primary liver cancer (intrahepatic cholangiocarcinoma and hepatocellular carcinoma) in a patient with hepatitis C virus-related cirrhosis.  J Hepatobiliary Pancreat Surg. 2007;  14(2) 204-209
  • 4 Fernández-Ruiz M, Guerra-Vales J M, Castelbón-Fernández F J, Llenas-García J, Caurcel-Díaz L, Colina-Ruizdelgado F. Multiple primary malignancies in Spanish patients with hepatocellular carcinoma: analysis of a hospital-based tumor registry.  J Gastroenterol Hepatol. 2009;  24(8) 1424-1430
  • 5 Chang J Y, Kim B H, Hong S W, Kim Y W, Oh J H. A case report of synchronous double primary liver cancers combined with early gastric cancer.  Korean J Intern Med. 2003;  18(2) 115-118
  • 6 Murata M, Matsuzaki K, Yoshida K et al.. Hepatitis B virus X protein shifts human hepatic transforming growth factor (TGF)-beta signaling from tumor suppression to oncogenesis in early chronic hepatitis B.  Hepatology. 2009;  49(4) 1203-1217
  • 7 Perumal V, Wang J, Thuluvath P, Choti M, Torbenson M. Hepatitis C and hepatitis B nucleic acids are present in intrahepatic cholangiocarcinomas from the United States.  Hum Pathol. 2006;  37(9) 1211-1216
  • 8 Bronowicki J P, Bineau C, Feugier P et al.. Primary lymphoma of the liver: clinical-pathological features and relationship with HCV infection in French patients.  Hepatology. 2003;  37(4) 781-787
  • 9 Suriawinata A, Thung S N. Hepatitis C virus and malignancy.  Hepatol Res. 2007;  37(6) 397-401
  • 10 Aita K, Seki K. Carcinosarcoma of the liver producing granulocyte-colony stimulating factor.  Pathol Int. 2006;  56(7) 413-419
  • 11 Lao X M, Chen D Y, Zhang Y Q et al.. Primary carcinosarcoma of the liver: clinicopathologic features of 5 cases and a review of the literature.  Am J Surg Pathol. 2007;  31(6) 817-826
  • 12 She R, Szakacs J. Carcinosarcoma of the liver: a case report and review of the literature.  Arch Pathol Lab Med. 2005;  129(6) 790-793
  • 13 Hamilton S R, Aaltonen L A. World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of the Digestive System. Lyon; IARC Press 2000
  • 14 Nomura K, Aizawa S, Ushigome S. Carcinosarcoma of the liver.  Arch Pathol Lab Med. 2000;  124 888-890
  • 15 Sumiyoshi S, Kikuyama M, Matsubayashi Y et al.. Carcinosarcoma of the liver with mesenchymal differentiation.  World J Gastroenterol. 2007;  13(5) 809-812
  • 16 Fayyazi A, Nolte W, Oestmann J W, Sattler B, Ramadori G, Radzun H J. Carcinosarcoma of the liver.  Histopathology. 1998;  32(4) 385-387
  • 17 Thompson L, Chang B, Barsky S H. Monoclonal origins of malignant mixed tumors (carcinosarcomas). Evidence for a divergent histogenesis.  Am J Surg Pathol. 1996;  20(3) 277-285
  • 18 Armstrong A B, Wang M, Eble J N et al.. TP53 mutational analysis supports monoclonal origin of biphasic sarcomatoid urothelial carcinoma (carcinosarcoma) of the urinary bladder.  Mod Pathol. 2009;  22(1) 113-118
  • 19 Sung M T, Wang M, MacLennan G T et al.. Histogenesis of sarcomatoid urothelial carcinoma of the urinary bladder: evidence for a common clonal origin with divergent differentiation.  J Pathol. 2007;  211(4) 420-430

Wen-Ming CongM.D. 

Department of Pathology, Eastern Hepatobiliary Surgery Hospital

Second Military Medical University, Changhai Road, Shanghai 200438, China

Email: wmcong@smmu.edu.cn

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