Department of Gastroenterology, Erciyes University, Medical School, Kayseri, Turkey.
Hepatobiliary Pancreat Dis Int. 2011 Feb;10(1):101-3.
Primary hepatic carcinosarcoma is a rare malignant tumor containing an intimate mixture of carcinomatous and sarcomatous elements. Reports on risk factors, epidemiology, and pathogenesis of the tumor as well as the experience in its treatment are limited.
We present a case of primary carcinosarcoma of the liver in a 69-year-old man who complained of right hypochondrial pain and weight loss for two months.
Magnetic resonance imaging revealed a 14 x 12 cm mass in segments 7-8 and 4 of the liver with vena hepatica invasion. An ultrasonography-guided biopsy showed osteoid tissue without osteoblastic rimming. Vascular structures accompanied the osteoid tissue. The patient underwent surgery after a diagnosis of hemangioma. Intraoperative frozen sections revealed a carcinosarcoma associated with an osteosarcoma and cholangiocellular carcinoma components.
Preoperative diagnosis of this rare primary hepatic malignant tumor may be difficult by biopsy owing to intratumoral heterogeneity. Highly mature areas of the osteosarcomatous component may lead to misdiagnosis of metaplastic bone tissue. Clinicopathologic features of this rare entity are discussed.
原发性肝肉瘤是一种罕见的恶性肿瘤，含有癌性和肉瘤性成分的密切混合。关于肿瘤的危险因素、流行病学和发病机制以及治疗经验的报告有限。
我们报告了一例 69 岁男性的原发性肝肉瘤病例，该患者因右季肋部疼痛和体重减轻两个月而就诊。
磁共振成像显示肝脏 7-8 段和 4 段有一个 14 x 12 cm 的肿块，伴有肝静脉侵犯。超声引导活检显示无成骨细胞包绕的骨样组织。血管结构伴随着骨样组织。在诊断为血管瘤后，患者接受了手术。术中冷冻切片显示与骨肉瘤和胆管细胞癌成分相关的癌肉瘤。
由于肿瘤内异质性，通过活检对这种罕见的原发性肝恶性肿瘤进行术前诊断可能较为困难。骨肉瘤成分中高度成熟的区域可能导致对骨组织的化生的误诊。讨论了这种罕见实体的临床病理特征。
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