2025 Volume 58 Issue 11 Pages 647-655
A 68-year-old man presented with jaundice and was suspected of having intraductal papillary neoplasm of the bile duct (IPNB). Imaging revealed an enhancing mass in the left hepatic duct, extending into the hilar bile duct and growing intrahepatically into segment 4 of the liver. An extended left hepatectomy with bile duct resection was performed. Pathological examination confirmed that the tumor originated intrahepatically, with the intraductal lesion identified as a tumor thrombus covered by normal bile duct epithelium. The tumor cells had a high nuclear-to-cytoplasmic (N/C) ratio compared to hepatocytes and cholangiocytes, and were arranged in a trabecular and microalveolar pattern throughout the tumor, with areas of partial stromal sclerosis. Immunohistochemical staining revealed that the tumor cells were dual positive for hepatocytic markers (AFP and glypican-3) and biliary markers (CK7 and CK20). Based on these findings, we diagnosed intermediate cell carcinoma of the liver, as classified in the 5th edition of the WHO classification. Intermediate cell carcinoma of the liver is a subtype of mixed-type hepatocellular carcinoma, which is newly classified as a distinct entity in the 5th edition of the WHO classification, differentiating it from the previously recognized mixed-type hepatocellular carcinoma. However, due to its rarity and the limited number of reported cases, many aspects of the clinical, pathological, and molecular characteristics of the disease remain unclear. In this report, we present a case diagnosed as intermediate cell carcinoma of the liver based on postoperative pathological findings, and we provide a review of the literature.
