A Case of Synchronous Double Cancer of the Liver Consisting of Cholangiolocellular and Hepatocellular Carcinomas in the Background of Chronic Hepatitis C

Abstract

A 71-year-old man who was pointed out having a tumorous lesion in the liver during clinical observation for chronic hepatitis C was admitted to our hospital. Abdominal CT scan showed a lesion in the segment 4 of the liver which was enhanced in the early phase and was washed out. CT during arterial portography (CTAP) revealed an area in the segment 6 to where portal blood flow diminished. CT hepatic arteriography (CTHA) showed early enhancement but revealed no clear wash out in the late phase. Atypical multiple liver cancer was diagnosed and the patient was operated on. Based on histopathological and immunohistochemical findings, synchronous double hepatic cancer, consisting of cholangiolocelullar carcinoma in the segment 4 and hepatocellular carcinoma in the segment 6, was diagnosed.
Both cholangiolocellular and hepatocellular carcinomas often have some underlying chronic hepatic disease as a background factor and so they provoke similar clinical features. However, synchronous occurrence of both malignancies is extremely rare and here we present the case together with a review of the literature.