Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2007 Feb 7;13(5):809-12.
doi: 10.3748/wjg.v13.i5.809.

Carcinosarcoma of the liver with mesenchymal differentiation

Shinichi Sumiyoshi  1 , Masataka Kikuyama, Yuji Matsubayashi, Fujito Kageyama, Yoshihiro Ide, Yoshimasa Kobayashi, Hirotoshi Nakamura
Affiliations
Case Reports

Carcinosarcoma of the liver with mesenchymal differentiation

Shinichi Sumiyoshi et al. World J Gastroenterol. .

Abstract

We report an extremely rare case where a mesenchymal differentiation, especially embryonal sarcoma, was demonstrated in cholangiocarcinoma. At autopsy, a yellowish-white tumor (15 cm x 12 cm) was found in the right hepatic lobe, and there were several daughter nodules in both hepatic lobes. Histologically, most of the main tumor and all of the daughter nodules examined showed sarcomatous changes (spindle cells, pleomorphic cells and hyalization). Histologic examination of a part of the main tumor disclosed a focus of adenocarcinoma within the tumor. The frequent transitions between the adenocarcinomatous areas and the sarcomatous areas suggested that sarcomatous transformation occurred in the cholangiocarcinoma and then spread rapidly. Immunohistochemically, the adenocarcinomatous elements were positive for cytokeratin, carcinoembryonic antigen (CEA) and epithelial membrane antigen, and negative in the sarcomatous cells. Vimentin was positive only in the sarcomatous elements. The findings of the present case support the view that carcinosarcomas represent carcinomas that develop sarcomatous elements via metaplasia of the epithelial element.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Magnetic resonance imaging showing hypointense areas in the right lobe of the liver on a T1-weighted image (A) and an inhomogeneously hyperintense mass on a T2-weighted image (B).
Figure 2
Figure 2
Needle biopsy showing a sarcomatous area consisting of interlacing bundles of atypical spindle cells [hematoxylin-eosin stain; magnification x 200 (A), x 100 (B)] and immunohistochemical staining showing positive α-SMA (C).
Figure 3
Figure 3
Gross appearance of hepatic tumor.
Figure 4
Figure 4
Spindle cells (A), pleomorphic areas (B), or hyalization (C) in leiomyosarcoma (hematoxylin-eosin stain; magnification x 160).
Figure 5
Figure 5
Cholangiocarcinoma focus (A) (hematoxylin-eosin stain; magnification x160), component surrounded by fibrosis (B) (hematoxylin-eosin stain; magnification x100), intimately mixed carcinomatous and sarcomatous components (C) (hematoxylin-eosin stain; magnification x 160).
Figure 6
Figure 6
Sarcomatous portion of the tumor consisting of undifferentiated (embryonal) sarcoma [hematoxylin-eosin stain; magnification x 25 (A, B), x 160 (C)].
See this image and copyright information in PMC

References

    1. Nakajima T, Kondo Y, Miyazaki M, Okui K. A histopathologic study of 102 cases of intrahepatic cholangiocarcinoma: histologic classification and modes of spreading. Hum Pathol. 1988;19:1228–1234. - PubMed
    1. Okuda K, Nakashima T. Primary carcinoma of the liver. 4th ed. In: Berk JE, editor. Bockus gastroenterology. Philadelphia: WB Saunders; 1985. pp. 3361–3364.
    1. Kakizoe S, Kojiro M, Nakashima T. Hepatocellular carcinoma with sarcomatous change. Clinicopathologic and immunohistochemical studies of 14 autopsy cases. Cancer. 1987;59:310–316. - PubMed
    1. Nakajima T, Kondo Y. A clinicopathologic study of intrahepatic cholangiocarcinoma containing a component of squamous cell carcinoma. Cancer. 1990;65:1401–1404. - PubMed
    1. Thompson L, Chang B, Barsky SH. Monoclonal origins of malignant mixed tumors (carcinosarcomas). Evidence for a divergent histogenesis. Am J Surg Pathol. 1996;20:277–285. - PubMed

Publication types