Abstract

Mixed hepatocellular and cholangiocarcinoma (HCC-CC) is an uncommon form of primary liver cancer. Definition of HCC-CC is both hepatocellular carcinoma and cholangiocarcinoma in the same tumor or in the same liver. We had experienced a case of HCC-CC. A 49 year-old male, who had social drinking history, admitted due to abdominal distension for about 4 days. Physical findings revealed that he had jaundice and ascites. The serum level of total bilirubin, direct bilirubin, AST, ALT, ALP and LDH were elevated. And serum levels of AFP and CEA were normal. But CA 19-9 level was elevated. Hepatitis B surface antibody was positive and anti-HCV antibody was negative. The level of SAAG was 1.4. The US and CT scans revealed heterogeneous echoic and hypodense multifocal mass like lesions were noted on the S6, S7, S8 and S5. And about 3 cm-sized hperechoic ovoid mass lesion was detected at S6. This lesions was not enhanced after contrast injection in CT scan. The IVC and hepatic veins were stenotic and right portal vein was obstructed due to thrombosis. But main portal vein, left portal vein and hepatic arteries were intact. We performed US　guide gun biopsy at this mass-like lesion in S6 and diagnosed as mixed hepatocellular and cholangiocarcinoma.

• Keywords: Mixed hepatocellular and cholangiocarcinoma