Clinical and Radio-Pathologic Features of Combined Hepatocellular and Cholangiocarcinoma

Keimyung Medical Journal 2008;27(2):125-132.

병합형 간세포암-담관암종의 임상적 및 방사선-병리학적인 양상

서혜진; 이석근; 정우진; 장병국; 박경식; 조광범; 황재석; 안성훈; 강구정; 권중혁; 강유나

Abstract

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

Key Words: combined hepatocellular carcinoma and cholangiocarcinoma