Sarcomatoid Cholangiocarcinoma of the Liver; a case study / 한국간담췌외과학회지

ABSTRACT

A 71 year-old man with persistent fever, right pleuritic pain and discomfort for 2 months was referred to hospital. An imaging study using ultrasonography, computed tomography and magnetic resonance imaging showed a huge hepatic mass, which was revealed to be a sarcoma-like mass of the right lobe of the liver. On laparotomy, 5, 6 and 7 segmentectomies were performed. The tumor was 18x16x15 cm in size. On cross section the tumor was a yellowish- fanning, diffusely soft, friable and clearly demarcated mass. Microscopically, the tumor cells were contained in the sarcomatous component (63%), tumor necrosis (36%) and adenocarcinoma component (0.6%) on histological mapping. Histologically, the tumor was composed of malignant osteoid tumor cells. Immunohistochemical staining for cytokeratin was positive in the sarcomatous components. These findings favored the possible epithelial origin of the sarcomatous cells. Thus, the diagnosis confirmed a sarcomatoid cholangiocarcinoma, with 2 osteosarcomatous components. After surgery, the pyrexia subsided, but early peritoneal and intrahepatic recurrence occurred 2 months postoperatively. He received systemic chemotherapy 6 times over 8 months, and partially responded. From our experienced the characteristics of this tumor have been found to be very aggressiveness, with poor prognosis.