Abstract
A 77-year-old man was followed up for hepatitis C. In 2005, an intrahepatic tumor was detected and he was diagnosed with boderline tumor. In September 2006, he consulted our hospital for tumor growth. Preoperative examination revealed a tumor (diameter, 40mm) in segment VII, a tumor (diameter, 35mm) in segment VI, and a 10-mm tumor that was irregular in shape, with no vascularity. A 15-mm tumor in segment VI and a 20-mm tumor in segment VII were suspected to be classical hepatocellular carcinoma. Three tumors without vascularity showed high intensity in a T2-weighted magnetic resonance image and a cluster of grape-like low echoic masses in an ultrasonogram. The 5 tumors mentioned above were surgically treated because they had a peculiar morphology and were suspected to be malignant. Histopathological analysis showed that the tumors without vascularity consisted of spindle cells. Immunohistochemical analysis showed that the tumor had a mixture of sarcomatous and epithelial components, and the patient was diagnosed with sarcomatoid carcinoma. The other 2 tumors were diagnosed as moderately differentiated hepatocellular carcinoma. There are few reports of sarcomatoid carcinoma with origin in the liver in the literature, and a unique ultrasonograph was obtained in our case.
