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Review
. 2024 May 27;16(5):766-775.
doi: 10.4254/wjh.v16.i5.766.

Combined hepatocellular cholangiocarcinoma: A clinicopathological update

Mukul Vij  1 , Fadl H Veerankutty  2   3 , Ashwin Rammohan  4 , Mohamed Rela  4
Affiliations
Review

Combined hepatocellular cholangiocarcinoma: A clinicopathological update

Mukul Vij et al. World J Hepatol. .

Abstract

Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare primary liver cancer associated with an appalling prognosis. The diagnosis and management of this entity have been challenging to physicians, radiologists, surgeons, pathologists, and oncologists alike. The diagnostic and prognostic value of biomarkers such as the immunohistochemical expression of nestin, a progenitor cell marker, have been explored recently. With a better understanding of biology and the clinical course of cHCC-CCA, newer treatment modalities like immune checkpoint inhibitors are being tried to improve the survival of patients with this rare disease. In this review, we give an account of the recent developments in the pathology, diagnostic approach, and management of cHCC-CCA.

Keywords: Biomarker; Cholangiocarcinoma; Combined hepatocellular-cholangiocarcinoma; Genomic landscape; Hepatocellular carcinoma; Immune checkpoint inhibitors; Immunotherapy; Liver cancer; Nestin; Pathology.

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Conflict of interest statement

Conflict-of-interest statement: There is no conflict of interest.

Figures

Figure 1
Figure 1
Combined hepatocellular-cholangiocarcinoma (HE, × 15).
Figure 2
Figure 2
Demonstrates immunohistochemical features of combined hepatocellular-cholangiocarcinoma. A: Hep-par1 immunostaining in hepatocellular component (× 5); B: Strong EMA immunostaining in cholangiocarcinoma component (× 3); C: Nestin immunostaining in a combined hepatocellular- cholangiocarcinoma (× 7.5).
See this image and copyright information in PMC

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