A rare case of carcinosarcoma of the liver

Abstract

A 72-year-old man was admitted to our hospital due to high grade fever. Ultra-sonography indicated a tumor in valving segments 3 to 4 of the liver. The tumor was suspected to be a liver abscess or a cholangiocarcinoma based on its heterogeneous density and low tumor enhancement on computed tomography. An aspiration biopsy showed undifferentiated carcinoma. Based on a preoperative diagnosis of intrahepatic cholangiocarcinoma or undifferentiated carcinoma, we conducted an extended left lobectomy. Histopathologically, the specimen showed osteoid and chondrocyte formation as well as clear cytoplasm and spindle-cell sarcoma with poorly formed cytoplasm. Immunostaining was positive for cytokeratin and glypican3, suggesting an original hepatocyte character. The final histological diagnosis was hepatic carcinosarcoma. The patient remains alive 5 months postoperatively. Hepatic carcinosarcoma is quite rare and could be among the differential diagnoses when a heterogenous low density tumor is found in the liver.