Abstract
AIM: To explore the clinical and pathological features of sarcomatoid hepatocellular carcinoma and to discuss its diagnosis, differential diagnosis, treatment and prognosis.
METHODS: One case of sarcomatoid hepatocellular carcinoma was treated at our hospital. The clinical, pathological, histopathological and immunohistological features, diagnosis and treatment of this disease were investigated. A literature review was performed to summarize the characteristics of the disease.
RESULTS: The tumor was located in the right lobe of the liver, demonstrating an infiltrative growth pattern. Histopathological and immunohistochemistry analyses showed coexistence of epithelial carcinoma and spindle cell sarcoma and presence of transitional area between carcinoma and sarcoma. Coagulative necrosis was noted in some areas of the tumor. Immunohistochemistrically, the tumor cells were strongly positive for CK (Pan) and EMA, weakly positive for AFP and Hepar-1, and negative for CK7, CK8, CK18, CK (H), CD34, CD117, Dog-1, Actin, SMA, Caldesmon, Desmin, CD10, CD21, CD23, CD35, CD1a, CD2, CD3, CD20, CD45, ALK, CD68, CD163, CD30, CD15, HMB45 and S-100.
CONCLUSION: Sarcomatoid hepatocellular carcinoma is a rare tumor with high malignancy. Clinically, differential diagnosis is needed to distinguish sarcomatoid hepatocellular carcinoma from hepatic carcinosarcoma, inflammatory follicular dendritic cell sarcoma and inflammatory myofibroblastoma. The prognosis of sarcomatoid hepatocellular carcinoma is correlated with tumor stage and morphological characteristics.
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