Combined Hepatocellular-Cholangiocarcinoma Associated With Radiofrequency Ablation for Hepatocellular Carcinoma

Susumu Takamatsu, Hiroto Nagano, Shunro Ootsukasa, Yasuyuki Kawachi, Hiroshi Maruyama


The patient was a 70-year-old male with liver cirrhosis associated with viral hepatitis C. He underwent radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) four times of in the 3 years prior to this reported event. Although he was closely followed after RFA by imaging every 3 - 4 months, a hypovascular and ill-defined tumor was revealed in segment IV of the liver by enhanced CT. The tumor expanded from the necrotic area associated with RFA performed 2 years prior. Because the tumor rapidly enlarged and was accompanied by a progressive tumor thrombus that filled the left portal vein, left hepatectomy was urgently performed. Histopathological examination of the resected specimen demonstrated that the tumor was mostly composed of moderately differentiated HCC. However, it also included obvious glandular structures with mucin production, which were immunohistochemically positive for both cytokeratin 7 and 19. These features are characteristic of cholangiocarcinoma; therefore the tumor was diagnosed as an uncommon combined hepatocellular-cholangiocarcinoma (cHCC-CC). From both pathological investigation and retrospective review of imaging results, the present cHCC-CC was presumed to derive from a locally recurring tumor with morphologic changes to the biliary phenotype induced by RFA for HCC. Both distant and intrahepatic metastases appeared 4 months after surgery and the patient died of cancer 15 months after surgery in spite of anti-cancer treatments.

J Med Cases. 2016;7(1):28-32


Combined hepatocellular-cholangiocarcinoma; Radiofrequency ablation; Hepatocellular carcinoma; Local recurrence; Morphologic change; Biliary phenotype; Liver resection

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.