Yoh Tomoaki, Kato Tatsushi, Hirohata Yoshiaki, Nakamura Yuya, Nakayama Hiroyuki, Okamura Ryuji
Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan.
Department of Surgery, Yamatotakada Municipal Hospital, Yamatotakada, Japan.
Clin J Gastroenterol. 2016 Aug;9(4):257-60. doi: 10.1007/s12328-016-0667-2. Epub 2016 Jun 30.
Cholangiolocellular carcinoma (CoCC) is a rare malignant liver tumor derived from hepatic progenitor cells, which exist in the canals of Hering. We encountered a case of CoCC with an extremely poor clinical course, initially showing abnormally elevated serum alfa-fetoprotein (AFP). A 72-year-old male presented with a liver tumor and abnormally elevated serum AFP levels (16,399 ng/ml). We preoperatively diagnosed hepatocellular carcinoma and performed extended right hepatectomy, after which the serum AFP levels remarkably decreased to 97 ng/ml. Postoperatively, the disease was pathologically diagnosed as CoCC. Furthermore, immunohistochemical pathological findings were alcian blue negative, cytokeratin (CK) 7 partially positive, CK19 positive, hepatocyte paraffin-1 negative, membranous negative for epithelial membrane antigen, and AFP negative. Fifty-five days later, intra- and extrahepatic recurrence developed, and the patient died 65 days after surgery. Although CoCCs show favorable outcomes, these characteristics of our case were not previously reported. It is necessary to accumulate more information on CoCC.
胆管细胞癌（CoCC）是一种源自肝祖细胞的罕见恶性肝肿瘤，肝祖细胞存在于赫林管中。我们遇到了一例临床病程极差的CoCC病例，最初表现为血清甲胎蛋白（AFP）异常升高。一名72岁男性因肝脏肿瘤和血清AFP水平异常升高（16399 ng/ml）就诊。我们术前诊断为肝细胞癌并进行了扩大右肝切除术，术后血清AFP水平显著降至97 ng/ml。术后，病理诊断为CoCC。此外，免疫组化病理结果显示阿尔辛蓝阴性、细胞角蛋白（CK）7部分阳性、CK19阳性、肝细胞石蜡-1阴性、上皮膜抗原膜性阴性、AFP阴性。55天后，出现肝内和肝外复发，患者术后65天死亡。尽管CoCC通常预后良好，但我们病例的这些特征此前未见报道。有必要积累更多关于CoCC的信息。
