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Korean J Hepatol. 2004 Jun;10(2):142-147. Korean. Case Report.
Kim JH , Lee YG , Lee J , Jung CK , Kim HT , Kang H , Kho KH , Hong SP , Hwang SG , Park PW , Rim GS .
Department of Internal Medicine, College of Medicine, Pochon CHA University, Korea.
Department of Pathology, College of Medicine, Pochon CHA University, Korea.

Combined hepatocellular-cholangiocarcinoma is a rare form of primary liver cancer, featuring both hepatocellular and biliary epithelial differentiations. An intrahepatic tumor may be considered as a metastatic lesion. It has been suggested in the literature that the likelihood of metastasis in the cirrhotic liver is lower than that in the non-cirrhotic liver. A rare case of combined hepatocellular-cholangiocarcinoma and second primary colon adenocarcinoma in a 67-year-old male patient with liver cirrhosis is presented. Histologically, the intrahepatic mass was composed of a spindle cell sarcomatous component; a hepatocellular carcinoma component; and a cholangiocarcinoma component. There were focal transitional regions among the different components. Immunohistochemically, the cholangiocarcinoma component of the intrahepatic mass showed positive reactions for CK-7 but negative reactions for CK-20. The adenocarcinoma of the colon showed positive reactions for CK-20 but negative reactions for CK-7.

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