Woulfe Fionn, Devine Michael, Hayes Brian, Crotty Rory, O'Sullivan Adrian
Mercy University Hospital, Grenville Place, Cork T12 WE28, Ireland.
Mercy University Hospital, Grenville Place, Cork T12 WE28, Ireland; Hermitage Blackrock Clinic/Royal College of Surgeons of Ireland, 121 St.Stephen's Green, Dublin, Ireland.
Int J Surg Case Rep. 2024 Nov;124:110366. doi: 10.1016/j.ijscr.2024.110366. Epub 2024 Sep 30.
Hepatocellular carcinoma is the most common form of primary liver cancer. Intrahepatic cholangiocarcinoma and fibrolamellar carcinoma make up most other cases. The vast majority of intrahepatic cholangiocarcinoma's are adenocarcinoma in nature. Few reports have indicated pure squamous cell or mixed squamous glandular histopathology.
We present the case of a 35-year-old female whose preoperative diagnosis indicated primary keratinizing squamous cell carcinoma (SCC) of the liver. However, histological analysis of surgical resections later confirmed intrahepatic cholangiocarcinoma composed of 95 % squamous and 5 % glandular features.
The change in diagnosis post-operatively is indicative of the pre-operative diagnostic difficulties associated with these newly classified variants. While adenomatous differentiation is the most common form of intrahepatic cholangiocarcinoma, a squamous and mixed histology can be observed.
Surgeons must be aware of new histological variants of cholangiocarcinoma, potential differentials, and direct further research to improve their poor prognosis.
肝细胞癌是原发性肝癌最常见的形式。肝内胆管癌和纤维板层癌构成了大多数其他病例。绝大多数肝内胆管癌本质上是腺癌。很少有报告指出其为纯鳞状细胞或混合鳞状腺组织病理学。
我们报告一例35岁女性病例,其术前诊断为原发性肝角化鳞状细胞癌(SCC)。然而,手术切除后的组织学分析后来证实为肝内胆管癌,其中95%为鳞状特征,5%为腺性特征。
术后诊断的改变表明了与这些新分类变体相关的术前诊断困难。虽然腺瘤样分化是肝内胆管癌最常见的形式,但也可观察到鳞状和混合组织学。
外科医生必须了解胆管癌的新组织学变体、潜在鉴别诊断,并指导进一步研究以改善其不良预后。