Abstract
The case was a female of 80 years of age who was pointed out in the other hospital that she had a left intrahepatic dilatated bile duct and a mild hepatic disorder, and was referred to and admitted in our hospital. The abdominal ultra-sonography and CT revealed a tumor image in the hepatic medial region, but the tumor markers such as AFP, PIVKA II, CEA and CA19-9 were found to be normal, and the viral hepatitis test also showed negative. We diagnosed it as cholangiocellular carcinoma, and performed left hepatic lobectomy. The tumor was covered by a film, with a well-defined boundary and its interior was a yellowish white solidity. Pathological diagnosis obtained the finding of mixed presence of well-differentiated tubular adenocarcinoma and sarcomatoid spindle cell carcinoma. However, any transitional form was not found between both the tumor cells. In immuno-staining, the section of well-differentiated tubular adenocarcinoma was positive for Cytokeratin 7 and Cytokeratin 19, and negative for Vimentin and smooth muscle actin (SMA). Also, the section of spindle cells was positive for Vimentin and SMA, and negative for Cytokeratin 7 and Cytokeratin 19. Hence we diagnosed the tumor as hepatic carcinosarcoma. As hepatic carcinosarcoma is a very rare disease, we report, centering on our case in Japan, including literature review.
