Abstract
The tumor of 5 cm in diameter found in segment 7 of the liver of a 59-year-old man with a history of hepatitis B was determined to be Cholangiocellular carcinoma (CCC) by computed tomography and angiography. Right lobectomy of the liver was performed in August 2003. The whitish firm mass without a capsule was found histopathologically to have both glandular and trabecular structures, as well as cholangiolocellular carcinoma (CoCC), and slight mucin production indicated by alcian blue staining. Immunohistochemistry results were as follows: cytokeratin (CK)-7 (+), -19 (+), -8 (+), Hep-Par1 (-). From the pattern of Epithelial membrane antigen (EMA) expression, the tumor was diagnosed as CoCC with CCC differentiation. Serum CEA and CA19-9 becoming normal postoperatively rose again two years later. The man died of mediastinal lymph node metastasis, multiple lung metastasis, and pleuritis carcinomatosa 3 years and 3 months after initial surgery. Both CoCC and combined hepatocellular and Cholangiocellular carcinoma may originate in hepatic progenitor cells and, indeed, may be the same disease.
