Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 7, Number 1, January 2016, pages 28-32

Combined Hepatocellular-Cholangiocarcinoma Associated With Radiofrequency Ablation for Hepatocellular Carcinoma


Figure 1.
Figure 1. Three-phase CT in June 2010. A 1-cm tumor observed in segment IV of the liver. The tumor was diagnosed as hepatocellular carcinoma from classical enhancement on three-phase CT. The tumor (arrow) was revealed to be hypervascular on early phase (A), and washed out on delayed phase (B).
Figure 2.
Figure 2. CT in November 2011. Slight bile duct dilatation (arrow) adjacent to necrotic area (arrowhead) caused by RFA.
Figure 3.
Figure 3. CT in May 2012. (A) An ill-defined tumor (arrowhead), which was adjacent to necrotic area (arrow) caused by RFA performed in July 2010, was demonstrated on delayed phase of CT. (B) CT depicted massive portal vein tumor thrombus (arrow) that filled left portal vein.
Figure 4.
Figure 4. Macroscopic finding of the resected specimen. On a cross-section of resected specimen, there was a white and unencapsulated tumor with massive portal vein tumor thrombus (arrow) that filled the left portal vein.
Figure 5.
Figure 5. Microscopic findings of the resected tumor (hematoxylin & eosin stain, × 100). (A) The tumor was mainly composed of moderately differentiated hepatocellular carcinoma, revealing a trabecular pattern. (B) The tumor included obvious glandular structures with mucin production and was regarded as cholangiocarcinoma.
Figure 6.
Figure 6. Immunohistochemical findings (× 100). The glandular structure in the present tumor was composed of the cells staining positive for both cytokeratin 19 (A) and cytokeratin 7 (B).