Two Resected Cases of Mixed Hepatocellular and Cholangiocellular Carcinoma

Abstract

Generally mixed hepatocellular and cholangiocellular carcinoma (MHCC) shows high malignancy as it has both the characteristics of hepatocellular carcinoma (HCC) and cholangiocellular carcinoma (CCC). Many cases of MHCC already have metastatic regions in the lung or lymph nodes when they are found clinically. Here we report two rare cases of MHCC resected curatively. Case 1: The patient was a 41-year-old man. US showed an abnormal tumor about 5 cm in diameter at the anterio-inferior segment of the liver, and right trisegmentectomy was performed. Case 2: The patient was a 56-year-old man. US showed a tumor about 3 cm in diameter at the posterio-inferior segment of the liver, and partial resection was performed. Histological findings in both cases showed the mixed type of MHCC according to Allen' s classification. Histologically, the HCC component and CCC component were mixed closely in Case 1, but the border of the two components was clear in Case 2. These findings may suggest that the origins were different in two cases. Hepatectomy associated with lymph node dissection of the hepatoduodenal ligament was performed in both cases, and the patients survived 42 and 16 months without reccurrence. This may suggest that if MHCC is supected at pre-or intraoperative examination, it is important to add lymph node dissection.