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Clinicopathologic study of mixed hepatocellular and cholangiocellular carcinoma: Modes of spreading and choice of surgical treatment by reference to macroscopic type
Author(s) -
Sasaki Atsushi,
Kawano Katsunori,
Aramaki Masanori,
Ohno Tsuyoshi,
Tahara Koichiro,
Takeuchi Yu,
Yoshida Takanori,
Kitano Seigo
Publication year - 2001
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/1096-9098(200101)76:1<37::aid-jso1007>3.0.co;2-0
Subject(s) - medicine , hepatocellular carcinoma , pathology , lymph node , portal vein , lymphadenectomy , carcinoma , gastroenterology
Background and Objectives Clinicopathologic features and the choice of surgical treatment for mixed hepatocellular and cholangiocellular carcinoma (MHC) remain controversial. Methods We evaluated the clinicopathological features of seven cases of MHC (one autopsied and six surgically resected cases). MHCs were divided into two classes by reference to macroscopic appearance: four were of the single nodular (SN) type and three were of the multinodular (MN) type. Results The mean age of patients and mean preoperative level of serum alpha‐fetoprotein were 44.5 years and 56,457 ng/ml for the SN type and 63.7 years and 1,227 ng/ml for the MN type, respectively. Histologically, invasion of the portal vein, the hepatic vein, and the perineural space was found in three, two, and zero cases of SN type tumors and in three, three, and one cases of MN type tumors, respectively. Lymph node metastases were found only in two patients with MN type MHC. Conclusions MHC of the SN type had a pattern of infiltration similar to hepatocellular carcinoma. By contrast, MHC of the MN type resembled intrahepatic cholangiocellular carcinoma. It is suggested that lymphadenectomy might be necessary for treatment of selected MHC, in particular MHC with a multinodular appearance. J. Surg. Oncol. 2001;76:37–46. © 2001 Wiley‐Liss, Inc.