Department of Medicine, Division of Hepatology, University of Miami School of Medicine, Miami, FL 33136, USA.
Dig Dis Sci. 2010 Dec;55(12):3597-601. doi: 10.1007/s10620-010-1402-3. Epub 2010 Sep 17.
Combined hepatocellular carcinoma and intrahepatic cholangiocarcinoma is a rare hepatobiliary malignancy incorporating components derived from both hepatocyte and intrahepatic bile duct epithelium. The natural history, treatment, and prognosis of this distinct cancer differ from hepatocellular carcinoma (HCC) or cholangiocarcinoma (CC) and are not completely understood. There is considerable controversy about the classification, treatment, and survival, which in turn is related to the rarity of the condition. Treatment options include surgical resection and the prognosis is believed to be better than CC but worse than HCC alone.
We report a single-center liver transplantation experience with the management of three patients with combined HCC-ICC with LT. Two patients were transplanted with presumed HCC within Milan criteria and the other patient was noted to have an incidental nodule in the explanted liver. Histomorphology and immunohistochemical studies revealed the presence of combined HCC-ICC in all three explants.
One patient died 144 days after LT due to metastatic tumor. The second patient is alive and is tumor free at 8.5 years post-LT, and the third patient died of metastatic tumor at 155 days after LT.
Good long-term survival can be achieved in at least some patients with this combined tumor type.
肝细胞癌和肝内胆管细胞癌合并症是一种罕见的肝胆恶性肿瘤，包含源自肝细胞和肝内胆管上皮的成分。这种独特癌症的自然史、治疗和预后与肝细胞癌（HCC）或胆管细胞癌（CC）不同，目前尚未完全了解。关于分类、治疗和生存率存在很大争议，而这反过来又与该病症的罕见性有关。治疗选择包括手术切除，据信其预后优于 CC，但比单独 HCC 差。
我们报告了在单个中心进行肝移植治疗三例 HCC-ICC 患者的经验。两名患者接受了符合米兰标准的 HCC 移植，另一名患者在移植肝脏中发现了一个偶然的结节。组织形态学和免疫组织化学研究显示，所有三个标本中均存在 HCC-ICC 合并症。
一名患者在 LT 后 144 天死于转移性肿瘤。第二名患者存活，LT 后 8.5 年无肿瘤，第三名患者在 LT 后 155 天死于转移性肿瘤。
对于这种合并肿瘤类型的至少一些患者，可实现良好的长期生存。
