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Ai H, Gong T, Ma Y, Ma G, Zhao J, Zhao X. Primary hepatic adenosquamous carcinoma: a case report and review of the literature. Front Oncol 2023; 13:1328886. [PMID: 38162486 PMCID: PMC10757360 DOI: 10.3389/fonc.2023.1328886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024] Open
Abstract
Primary hepatic adenosquamous carcinoma is considered a rare subtype of intrahepatic cholangiocarcinoma, with fewer than 100 domestic and international cases reported. This malignancy exhibits a high degree of malignancy, strong invasiveness, and an unfavorable prognosis due to its propensity for early lymph node and intrahepatic metastasis. The etiology of this disease remains uncertain, and preoperative diagnosis is exceedingly challenging owing to the nonspecific clinical features and lack of specificity in imaging studies. Radical surgical resection is the most effective treatment for non-metastatic tumors, while targeted adjuvant therapy administered postoperatively can enhance therapeutic efficacy and delay tumor recurrence. This article documents the diagnostic and therapeutic course of a case of primary hepatic adenosquamous carcinoma treated at our medical institution, along with a comprehensive synthesis of the clinical characteristics and advances in the diagnosis and treatment of this disease, aiming to augment understanding and serve as a reference for future clinical endeavors.
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Affiliation(s)
- Haidong Ai
- Hepatobiliary and Pancreatic Medical Center, The First Affiliated Hospital of Weifang Medical College (Weifang People’s Hospital), Weifang, China
| | - Ting Gong
- Department of Ophthalmology, The First Affiliated Hospital of Weifang Medical College (Weifang People’s Hospital), Weifang, China
| | - Yongbiao Ma
- Hepatobiliary and Pancreatic Medical Center, The First Affiliated Hospital of Weifang Medical College (Weifang People’s Hospital), Weifang, China
| | - Guixu Ma
- Hepatobiliary and Pancreatic Medical Center, The First Affiliated Hospital of Weifang Medical College (Weifang People’s Hospital), Weifang, China
| | - Jingjing Zhao
- Hepatobiliary and Pancreatic Medical Center, The First Affiliated Hospital of Weifang Medical College (Weifang People’s Hospital), Weifang, China
| | - Xuelin Zhao
- Hepatobiliary and Pancreatic Medical Center, The First Affiliated Hospital of Weifang Medical College (Weifang People’s Hospital), Weifang, China
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Okuda Y, Abe T, Ikeda M, Kurihara K, Shimizu A, Oshita A, Yonehara S, Hanada K. Curative surgery for primary squamous cell carcinoma of the liver: a rare case study. Clin J Gastroenterol 2022; 16:263-269. [PMID: 36481843 DOI: 10.1007/s12328-022-01740-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
Primary squamous cell carcinoma (SCC) of the liver is an extremely rare disease with a very poor prognosis. An 83-year-old woman was referred to our hospital with left abdominal pain. Laboratory data showed mildly elevated C-reactive protein and biliary enzymes. The tumor markers carcinoembryonic antigen, alpha-fetoprotein, and carbohydrate antigen 19-9 were within normal ranges. Contrast-enhanced computed tomography revealed a 60 mm-sized low-density mass with poor contrast enhancement located in the lateral segment of the liver. The tumor showed low signal on T1-weighted magnetic resonance imaging (MRI) and high signal on T2-weighted MRI. The cytology of bile juice showed no malignant findings. Endoscopic ultrasound-guided fine-needle aspiration biopsy was performed, which was suggestive of primary hepatic SCC. Tumor markers cytokeratin 19 fragment (CYFRA) and SCC-related antigen were elevated, at 25.2 ng/mL and 14.7 ng/mL, respectively. Left lobectomy and hilar lymph node dissection were performed. One month after surgery, the tumor marker values showed a marked decrease of 1.8 ng/mL for CYFRA and 0.3 ng/dL for SCC-related antigen. The patient has been without recurrence for more than one and half year postoperatively. SCC-related antigen and CYFRA were markedly decreased after tumor resection in this case, which may suggest their utility as tumor markers for SCC of liver origin.
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Affiliation(s)
- Yasuhiro Okuda
- Department of Gastroenterology, Onomichi General Hospital, 1-10-23 Hirahara, Onomichi City, Hiroshima, 722-8508, Japan
| | - Tomoyuki Abe
- Department of Surgery, Onomichi General Hospital, 1-10-23 Hirahara, Onomichi City, Hiroshima, 722-8508, Japan.
| | - Morito Ikeda
- Department of Gastroenterology, Onomichi General Hospital, 1-10-23 Hirahara, Onomichi City, Hiroshima, 722-8508, Japan
| | - Keisuke Kurihara
- Department of Gastroenterology, Onomichi General Hospital, 1-10-23 Hirahara, Onomichi City, Hiroshima, 722-8508, Japan
| | - Akinori Shimizu
- Department of Gastroenterology, Onomichi General Hospital, 1-10-23 Hirahara, Onomichi City, Hiroshima, 722-8508, Japan
| | - Akihiko Oshita
- Department of Surgery, Onomichi General Hospital, 1-10-23 Hirahara, Onomichi City, Hiroshima, 722-8508, Japan
| | - Shuji Yonehara
- Department of Pathology, Onomichi General Hospital, 1-10-23 Hirahara, Onomichi City, Hiroshima, 722-8508, Japan
| | - Keiji Hanada
- Department of Gastroenterology, Onomichi General Hospital, 1-10-23 Hirahara, Onomichi City, Hiroshima, 722-8508, Japan
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Watanabe Y, Osaki A, Kimura K, Yakubo S, Takaku K, Sato M, Hashidate H, Waguri N, Terai S. Unresectable primary hepatic adenosquamous carcinoma successfully treated with systemic and transcatheter hepatic arterial injection chemotherapies followed by conversion surgery: a case report and literature review. BMC Gastroenterol 2021; 21:491. [PMID: 34930149 PMCID: PMC8686661 DOI: 10.1186/s12876-021-02070-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/13/2021] [Indexed: 02/08/2023] Open
Abstract
Background Primary hepatic adenosquamous carcinoma (ASC) is a type of tumor that has the features of both adenocarcinoma and squamous cell carcinoma (SCC). The prognosis for patients with ASC is poor, as the chemotherapy has been ineffective so far. Case presentation Here, we report a case of a 62-year-old male patient who presented with high fever. The tumor marker levels were high, and abdominal dynamic computed tomography showed a liver tumor and distant lymph node metastases. Upon further investigation, needle biopsy of the liver tumor showed a primary hepatic SCC. Because the SCC was unresectable, the patient was treated with tegafur/gimeracil/oteracil (S-1) and transcatheter hepatic arterial injection (TAI) of cisplatin. After chemotherapy, a surgical resection performed on the remaining liver tumor, made the patient cancer-free. After the operation, the liver tumor was confirmed as primary hepatic ASC. Subsequently, the patient was administered postoperative adjuvant chemotherapy, which prevented its recurrence. Conclusions Due to the lack of an effective treatment for primary hepatic ASC, its prognosis is poor. Here, we suggest that a chemotherapy combination of 5-fluorouracil (S-1) and cisplatin along with conversion surgery might be an effective way for treating primary hepatic ASC. Our experience from this case shall be valuable to clinicians around the world involved in the treatment of primary hepatic ASC.
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Filizoglu N, Oksuzoglu K, Ozguven S. Primary Adenosquamous Carcinoma of the Liver on FDG PET/CT. Clin Nucl Med 2021; 46:e572-e573. [PMID: 34034322 DOI: 10.1097/rlu.0000000000003726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Primary adenosquamous carcinoma (ASC) of the liver is a rare subtype of intrahepatic cholangiocarcinoma. Hepatic ASC consists of both adenocarcinoma and squamous cell carcinoma components. Because hepatic ASC is extremely rare, only a few cases describing the imaging findings of hepatic ASC were reported before. Herein, we present FDG PET/CT findings of hepatic ASC in a 78-year-old woman who was admitted to hospital with a 4-week history of right upper quadrant pain.
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Affiliation(s)
- Nuh Filizoglu
- From the Department of Nuclear Medicine, Marmara University Pendik Training and Research, Hospital, Istanbul, Turkey
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Nosaka T, Ohtani M, Namikawa S, Takahashi K, Naito T, Ofuji K, Matsuda H, Hiramatsu K, Imamura Y, Nakamoto Y. Advanced primary adenosquamous carcinoma of the liver with a small cell carcinoma component: an autopsy case report. Clin J Gastroenterol 2021; 14:1496-1502. [PMID: 34216375 DOI: 10.1007/s12328-021-01474-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/28/2021] [Indexed: 01/29/2023]
Abstract
Primary adenosquamous carcinoma (ASC) of the liver is a rare subtype of cholangiocarcinoma that comprises both adenocarcinoma and squamous cell carcinoma components. We report a 48-year-old woman with advanced primary ASC and small cell carcinoma of the liver who had extrahepatic metastasis and received multiple chemotherapy regimens. After first presenting with upper abdominal pain, imaging revealed a 10.2 × 9.5 cm mass in the right lobe of the liver with lymph node and lung metastases. A liver tumor biopsy revealed adenocarcinoma and squamous cell carcinoma components, leading to a diagnosis of advanced primary ASC of the liver. The tumor shrank with gemcitabine/cisplatin therapy; however, neuron-specific enolase (NSE) and CYFRA levels were increased and the tumor grew. Next, hepatic arterial infusion chemotherapy using 5-fluorouracil and cisplatin decreased NSE and CYFRA levels and suppressed tumor growth. However, due to tumor growth, she died 14 months post-initial diagnosis. Post-autopsy pathology revealed a mixture of CD56- and synaptophysin-positive small cell carcinoma component in addition to ASC. We report a rare advanced primary ASC with small cell carcinoma of the liver diagnosed at autopsy.
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Affiliation(s)
- Takuto Nosaka
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Masahiro Ohtani
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Shouichi Namikawa
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Kazuto Takahashi
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Tatsushi Naito
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Kazuya Ofuji
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hidetaka Matsuda
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Katsushi Hiramatsu
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Yoshiaki Imamura
- Division of Diagnostic Pathology/Surgical Pathology, University of Fukui Hospital, Fukui, Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
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Aso K, Ito K, Takemura N, Inagaki F, Mihara F, Kokudo N. Transverse colon invasion from intrahepatic cholangiocarcinoma with lymph node metastasis in the regional mesocolon: a case report. Surg Case Rep 2020; 6:248. [PMID: 33000392 PMCID: PMC7527392 DOI: 10.1186/s40792-020-01010-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/19/2020] [Indexed: 12/26/2022] Open
Abstract
Background Intrahepatic cholangiocarcinoma (ICC) is an aggressive cancer with high frequency of extrahepatic metastasis at diagnosis. However, there have been very few reports of direct invasion to transverse mesocolon with lymph node metastasis in the regional mesocolon. Case presentation A 71-year-old man presented to our hospital with anorexia and weight loss. Abdominal computed tomography (CT) revealed enlarged gallbladder wall with intrahepatic tumor extended from the gallbladder. The transverse colon was located adjacent to the gallbladder and its wall was thickened, indicating tumor invasion. Some enlarged lymph nodes were observed in the transverse mesocolon, suggesting metastatic or inflammatory lymph node swelling. Percutaneous liver biopsy detected poorly differentiated adenocarcinoma. After confirming the absence of remote metastasis and peritoneal dissemination, surgical resection including right hepatectomy and right hemicolectomy was performed. The pathological diagnosis was adenosquamous carcinoma of the liver and lymph node metastasis in the transverse mesocolon. The surgical margins were negative and R0 resection was achieved. Although adjuvant chemotherapy was administered, follow-up CT detected multiple metastases to the lung 4 months after surgery. The patient died 12 months after the operation. Conclusions Direct colon invasion from ICC may cause lymph node metastasis in the regional mesocolon. Careful assessment is necessary for the diagnosis of enlarged lymph nodes in ICC with direct colon invasion.
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Affiliation(s)
- Kenta Aso
- Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Kyoji Ito
- Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Nobuyuki Takemura
- Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
| | - Fuyuki Inagaki
- Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Fuminori Mihara
- Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Norihiro Kokudo
- Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
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Daiku K, Fukuda K, Morimoto O, Takiuchi D, Shimakoshi H, Kegasawa T, Yamaguchi Y, Kogita S, Sawai Y, Nakahara M, Igura T, Shibata K, Imai Y. Primary adenosquamous carcinoma of the liver detected during cancer surveillance in a patient with primary sclerosing cholangitis. Clin J Gastroenterol 2020; 13:1273-1279. [PMID: 32785892 DOI: 10.1007/s12328-020-01204-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023]
Abstract
Primary sclerosing cholangitis (PSC) is associated with significant risk for hepatobiliary cancers. Primary hepatic adenosquamous carcinoma (ASC), a rare subtype of cholangiocarcinoma, is composed of both adenocarcinoma and squamous cell carcinoma components. We herein report the case of a patient with PSC who was diagnosed with ASC of the liver during cancer surveillance. A 74-year-old male patient was diagnosed with PSC based on blood chemistry and magnetic resonance cholangiopancreatography findings, and regular surveillance for hepatobiliary cancers was initiated. Four years later, the level of carbohydrate antigen 19-9 rapidly increased, and abdominal imaging studies revealed a cystic mass, 40 mm in diameter, containing a solid component in the right liver lobe. Right lobectomy was performed with a pre-operative diagnosis of cholangiocarcinoma; however, the definitive diagnosis was ASC based on the presence of adenocarcinoma and squamous cell carcinoma components in the resected tumor. The patient did not receive post-operative chemotherapy, but was alive for more than 4 years without recurrence at last follow-up. The present case illustrates that regular surveillance and curative resection might achieve long-term survival in hepatic ASC, which has a poor prognosis.
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Affiliation(s)
- Kazuma Daiku
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan
| | - Kazuto Fukuda
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan.
| | - Osakuni Morimoto
- Department of Gastroenterological Surgery, Ikeda Municipal Hospital, Ikeda, Osaka, Japan
| | - Daisuke Takiuchi
- Department of Gastroenterological Surgery, Ikeda Municipal Hospital, Ikeda, Osaka, Japan
| | - Hiromi Shimakoshi
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan
| | - Tadashi Kegasawa
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan
| | - Yoshitaka Yamaguchi
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan
| | - Sachiyo Kogita
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan
| | - Yoshiyuki Sawai
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan
| | - Masanori Nakahara
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan
| | - Takumi Igura
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan
| | - Kunitaka Shibata
- Department of Gastroenterological Surgery, Ikeda Municipal Hospital, Ikeda, Osaka, Japan
| | - Yasuharu Imai
- Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan
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Zhou SY, Qiao ZG, Li CL, Chen TB. Primary adenosquamous carcinoma of the liver. Kaohsiung J Med Sci 2020; 36:857-858. [PMID: 32562565 DOI: 10.1002/kjm2.12252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/10/2020] [Accepted: 05/28/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
- Shuai-Yang Zhou
- Department of Gastroenterology, Suzhou Ninth People's Hospital, Affiliated Wujiang Hospital of Nantong University, Suzhou, China
| | - Zhen-Guo Qiao
- Department of Gastroenterology, Suzhou Ninth People's Hospital, Affiliated Wujiang Hospital of Nantong University, Suzhou, China
| | - Chun-Liang Li
- Department of Gastroenterology, Suzhou Ninth People's Hospital, Affiliated Wujiang Hospital of Nantong University, Suzhou, China
| | - Tian-Bao Chen
- Department of Gastroenterology, Suzhou Ninth People's Hospital, Affiliated Wujiang Hospital of Nantong University, Suzhou, China
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Boscolo G, Jirillo A, Da Pian P. Complete Remission of Poorly Differentiated Squamous Liver Carcinoma after Systemic Chemotherapy and Surgery a Case Report. TUMORI JOURNAL 2019; 91:71-2. [PMID: 15850008 DOI: 10.1177/030089160509100113] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report the case of a 64-year-old male patient diagnosed as having inoperable poorly differentiated liver carcinoma that could be completely resected after systemic chemotherapy with cisplatin and 5-fluorouracil.
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Affiliation(s)
- Giorgia Boscolo
- Division of Medical Oncology, Azienda Ospedaliera, Padua, Italy
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Abstract
Primary squamous cell carcinoma (SCC) of liver is rare, and its prognosis is extremely poor. This study aims at reviewing the clinical data of all pathologically diagnosed liver cancer in our institute, and discussing the clinical presentation, diagnosis, treatment, and prognosis of our cases of SCC and the literatures reported previously. All the patients undergoing liver surgery or biopsy for liver cancers from 2002 to 2013 in our hospital were reviewed, and the liver specimens were examined pathologically. A literature search for case reports of primary SCC of liver published until December 31, 2014, was performed on PubMed, MEDLINE, Scopus Elsevier, Cochrane, and Google Scholar. The primitive data of the case reports were all included and analyzed if available. From January 2002 to October 2013, 2210 cases of liver cancer were diagnosed pathologically in our hospital. Among, 4 cases (0.2%) were diagnosed as primary SCC of liver. All were negative for hepatitis B infection, but present with liver cyst and/or hepatolithiasis. One patient underwent radical resection, but died of tumor recurrence 18 months postoperatively. One patient received transcatheter arterial chemoembolization and 1 patient received laparotomy and alcohol injection, but died 9 and 4 months after surgery, respectively. The last patient received only biopsy and supportive treatment, and finally died of tumor metastasis 6 months later. From 1970 to 2014, 31 cases of primary liver SCC have been published in English previously. Thirty one cases and the 4 cases in the present study were included. The average age of the patients were 54 years (range 18-83), with a male to female ratio of 19:16. Twenty patients had liver cysts, 7 had bile duct stones, and 2 cases had both. Patients undergoing radical surgery had better prognosis than those undergoing palliative treatments (median survival 17 vs 5 months, P = 0.005, log-rank test). Patients with liver cysts seemed to have worse prognosis than those with bile duct stones (median survival 7 vs 18 months, P = 0.090, log-rank test). Primary liver SCC seems to be mostly originated from liver cyst or hepatolithiasis. Radical surgery should be firstly recommended, although the prognosis might be unfavorable.
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Affiliation(s)
- Xu-Feng Zhang
- From the Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province, PR China (X-FZ, Z-QD, X-ML, YL)
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Yan L, Xie F, Yang C, Yu L, Zheng T, Fu J, Yang J. The comparison of surgical patients with primary hepatic squamous cell carcinoma or adenosquamous carcinoma and surgical patients with hepatocellular carcinoma. World J Surg Oncol 2015; 13:90. [PMID: 25890009 PMCID: PMC4358902 DOI: 10.1186/s12957-015-0464-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 01/17/2015] [Indexed: 12/11/2022] Open
Abstract
Background There are still several controversies and ambiguities in the aspects of primary hepatic squamous cell carcinoma and primary hepatic adenosquamous carcinoma. To further clarify the specific features of these two infrequent diseases and provide beneficial propose for clinical decision, we did this retrospective study. Methods We reviewed the clinical features and outcomes of three primary hepatic squamous cell carcinoma (SCC) patients and six primary hepatic adenosquamous carcinoma (ASC) patients from January 1998 to December 2011 in Eastern Hepatobiliary Surgery Hospital in China. Meanwhile, 40 hepatocellular carcinoma (HCC) patients and 26 metastatic hepatic SCC or ASC patients who were hospitalized in the same period were also reviewed to make a comparison. In order to find out the definite survival information of SCC and ASC patients, 30 previous studies containing 37 primary hepatic SCC (16) and ASC (21) patients were reviewed, and their information of survival was analyzed together with the included patients in our hospital. Results Serum tumor markers showed significant differences between primary hepatic SCC/ASC and HCC patients, especially for serum alpha fetal protein (AFP) level and carbohydrate antigen 19-9 (CA 19-9). On the pathologic performance, primary SCC/ASC tumor was rarely accompanied with tumor capsule. They presented peripheral hepatic lymph node metastasis more likely and showed low proportion of microvascular invasion. The median survival time of primary hepatic SCC/ASC patients after liver resection (LR) was 15 months. And the 1-, 3-, 5-year survival rates after LR were 60%, 24%, and 12%, respectively. Significant difference was not discovered when SCC and ASC patients were compared with HCC patients (P = 0.294). The median survival time after LR for primary SCC and ASC patients was respectively 23 months and 13 months. Conclusions The comprehensive application of some clinical characteristics, histopathologic features, and imaging findings may be useful for us in making definite diagnoses for primary hepatic SCC and ASC patients preoperatively. And the treatment of liver resection was effective for those patients who met the selection criteria for liver resection.
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Affiliation(s)
- Long Yan
- Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Hospital, the Second Military Medical University, 255 Changhai Road, Shanghai, 200438, China.
| | - Feng Xie
- Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Hospital, the Second Military Medical University, 255 Changhai Road, Shanghai, 200438, China.
| | - Cheng Yang
- Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Hospital, the Second Military Medical University, 255 Changhai Road, Shanghai, 200438, China.
| | - Lihan Yu
- Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Hospital, the Second Military Medical University, 255 Changhai Road, Shanghai, 200438, China.
| | - Tao Zheng
- Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Hospital, the Second Military Medical University, 255 Changhai Road, Shanghai, 200438, China.
| | - Jun Fu
- Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Hospital, the Second Military Medical University, 255 Changhai Road, Shanghai, 200438, China.
| | - Jiamei Yang
- Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Hospital, the Second Military Medical University, 255 Changhai Road, Shanghai, 200438, China.
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Shimizu S, Oshita A, Tashiro H, Amano H, Kobayashi T, Tanaka M, Arihiro K, Ohdan H. Synchronous double cancers of primary hepatic adenosquamous carcinoma and hepatocellular carcinoma: report of a case. Surg Today 2012; 43:418-23. [PMID: 23014833 DOI: 10.1007/s00595-012-0346-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 12/12/2011] [Indexed: 12/13/2022]
Abstract
A 76-year-old male was referred for the treatment of liver tumors detected by abdominal computed tomography (CT). Dynamic CT revealed a low-density tumor with an irregularly enhanced rim in the left lateral sector, and a highly enhanced, well-circumscribed tumor in the caudate lobe, accompanied by dilation of the intrahepatic biliary ducts in the left lobe. Preoperative imaging studies led to the diagnosis of double cancers consisting of intrahepatic cholangiocarcinoma and hepatocellular carcinoma (HCC). Left hemihepatectomy with caudate lobectomy was performed. The postoperative course was uneventful. Microscopic evaluation revealed that the tumor in the left lateral sector was adenosquamous carcinoma (ASC), whereas that in the caudate lobe was HCC. This report presents the first case describing the resection of synchronous double cancers of primary hepatic ASC and HCC.
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Affiliation(s)
- Seiichi Shimizu
- Department of Surgery, Division of Frontier Medical Science Graduate School of Biochemical Sciences, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
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13
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Affiliation(s)
- Shin Young Park
- Department of Pathology, Konyang University College of Medicine, Daejeon, Korea
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14
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Adenosquamous carcinoma of the extrahepatic bile duct: clinicopathologic and radiologic features. ACTA ACUST UNITED AC 2008; 34:217-24. [PMID: 18204917 DOI: 10.1007/s00261-008-9363-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND To retrospectively analyze computed tomography (CT) features of adenosquamous carcinoma (ASC) of the extrahepatic bile duct and to correlate them with pathologic findings. METHODS Six patients who underwent radical surgical resection for ASC of extrahepatic bile duct were included. CT and pathologic findings were analyzed and correlated with each other. RESULTS Five ASCs were periductal infiltrative type and the remaining one was intraductal polypoid type. Histologically, ASC was composed of squamous and glandular components which mixed in an intermingled pattern and was characterized by a high local aggressiveness mainly due to the squamous component. The most common CT findings were a segmental wall thickening with delayed enhancement. Overall, CT features were well correlated with pathologic findings. However, CT tended to underestimate radial extent of the tumor compared with histologic findings. CONCLUSIONS Histopathologically, ASC of the extrahepatic bile duct is characterized by greater local aggressiveness. However, their CT findings are not quite different from those of usual adenocarcinoma due to the unique geographic characteristic of being located at a very limited space.
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Yokota H, Matoba M, Tonami H, Hasegawa T, Saito H, Kurose N. Imaging findings in primary adenosquamous carcinoma of the liver: a case report. Clin Imaging 2007; 31:279-82. [PMID: 17599625 DOI: 10.1016/j.clinimag.2007.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2006] [Accepted: 01/11/2007] [Indexed: 02/08/2023]
Abstract
Adenosquamous cell carcinoma is characterized by both squamous and glandular components, and is a rare disease of the liver that is the subject of few reports in the literature. We present a case in which the imaging findings on CT, MRI, and hepatic arteriography, as well as pathological correlation of the tumor and the clinical history, aided in including this entity in the differential diagnosis.
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Affiliation(s)
- Hajime Yokota
- Department of Diagnostic and Therapeutic Radiology, Kanazawa Medical University, Uchinada, Ishikawa 920-0293, Japan.
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Zhang Z, Nonaka H, Nagayama T, Hatori T, Ihara F, Zhang L, Akima M, Shiba T. Double cancer consisting of adenosquamous and hepatocellular carcinomas of the liver. Pathol Int 2001; 51:961-4. [PMID: 11844070 DOI: 10.1046/j.1440-1827.2001.01302.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A very rare case of a double cancer consisting of adenosquamous and hepatocellular carcinomas of the liver in a 65-year-old-man is discussed. The patient was hospitalized with epigastralgia in May 1997. Abdominal computed axial tomography revealed a tumor located in the left lobe of the liver and a left hepatic lobectomy was performed. The tumor recurred several months after surgery and the patient died on 4 June 1999. At autopsy, both a major tumor mass with extensive involvement, located in the surgical margin, and a small mass located in S7 were discovered. Microscopically, the major tumor was diagnosed as adenosquamous carcinoma and the small one in S7 as hepatocellular carcinoma. To our knowledge, this is the first case of a double cancer consisting of adenosquamous and hepatocellular carcinomas of the liver. The pathological findings support the hypothesis that this tumor developed as a squamous transformation of adenocarcinoma.
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Affiliation(s)
- Z Zhang
- First Department of Pathology, Toho University School of Medicine, Tokyo, Japan.
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17
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Kwon OS, Lee HS, Koh DW, Cho YJ, Park YH, Park DK, Oh YL, Seo JH, Chun HJ, Um SH, Lee SW, Choi JH, Kim CD, Ryu HS, Hyun JH, Kim AR, Kim YS. A case of primary adenosquamous carcinoma of the liver presented with liver abscess. Korean J Intern Med 2001; 16:270-3. [PMID: 11855159 PMCID: PMC4578056 DOI: 10.3904/kjim.2001.16.4.270] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Primary adenosquamous carcinoma of the liver is a very rare type of cholangiocarcinoma and is defined as a cancer containing both squamous and adenomatous components in the same lesion. Recently, we experienced a primary adenosquamous carcinoma of the liver presented as liver abscess. A 63-year-old man was presented with a 4-day history of fever and chill. The radiologic study showed a 4 cm-sized, central hypoattenuated mass with peripheral rim enhancement in the left lobe of the liver. Ultrasonography-guided aspiration and biopsy suggested an adenocarcinoma with abscess in the liver. At laparotomy, the tumor occupied the left lobe of the liver and invaded the right diaphragm. An extended left lobectomy and a partial excision of the involved diaphragm were done. Grossly, the tumor was 6 x 5 x 5 cm in size and had an eccentric necrosis. Microscopically, the tumor was composed of adenocarcinoma and squamous cell carcinoma with a transitional area.
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Affiliation(s)
- O S Kwon
- Department of Internal Medicine, Korea University, Ansan Hospital, 516 Kojan-Dong, Ansan City, Kyungki-Do, 425-020, Korea
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