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정봉주 ( Jeong Bong Ju ),현동효 ( Hyeon Dong Hyo ),이경욱 ( Lee Gyeong Ug ),류성태 ( Lyu Seong Tae ),이진우 ( Lee Jin U ),이정일 ( Lee Jeong Il ),정석 ( Jeong Seog ),이돈행 ( Lee Don Haeng ),김범수 ( Kim Beom Su ),김형길 ( Kim Hy 대한소화기학회 2004 대한소화기학회지 Vol.43 No.1
Combined hepatocellular-cholangiocarcinoma (HCC-CC) with sarcomatoid features is an extremely rare primary liver cancer, of which only four cases have been reported. We report a case of sarcomatoid combined HCC-CC in a 60-year-old woman who complained of right upper quadrant pain and presented with a 7 cm mass in the S4 region of the liver in abdominal CT. Ultrasonography-guided needle biopsy diagnosed it as HCC, and left lobectomy of the liver followed. Microscopically, the tumor consisted of two portions: HCC portion showing trabecular pattern, which had partially sarcomatous area with spindle-shaped tumor cells, and CC portion with glandular pattern. Immunohistochemically, HCC portion reacted positively with α-fetoprotein while CC portion demonstrated positive reactivity with carcinoembryonic antigen and mucicarmine. Sarcomatoid cells reacted positively for cytokeratin. She died of tumor recurrence and hepatic failure 12 months after the operation. Combined HCC-CC has poor prognosis, and sarcomatoid HCC has high metastatic potential and poor prognosis compared with ordinary HCC. (Korean J Gastroenterol 2004;43:56-60)