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Journal of the Korean Liver Cancer Study 2002;2(1):83-87.
Published online July 31, 2002.
A Case of Mixed Hepatocellular and Cholangiocarcinoma
Jae Hyuk Do1, Joong-Won Park1, Hyung Joon Kim1, Eon Seob Park2, Jong Beom Lee3, Byung Chul Yoo1, Sill Moo Park1
1Department of Internal Medicine, Chung-Ang University College of Medicine
2Department of Pathology, Chung-Ang University College of Medicine
3Department of Radiology, Chung-Ang University College of Medicine
Correspondence:  Joong-Won Park,
Email: jwpark@ncc.re.kr
Copyright ©2002 by The Korean Liver Cancer Association
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.
Key Words: Mixed hepatocellular and cholangiocarcinoma
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