The cHCC-CC is a rare variant of primary liver cancers (0.87%–4.7%), comprising elements of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). The history of cHCC-CC's classification started in 1949, with Allen and Lisa that described cHCC-CC and classified it into three subtype. Type A or "double cancer" represents cases in which HCC and CC exist separately; type B, "combined" type, HCC and CC components exist contiguously, but independently; and type C, "mixed" type, occurs when HCC and CC components are admixed within a mass. More...

Study Population The database of the Department of Pathology from December 2004 to January 2012 was cross-referenced with the database of Departement of Radiology to identify all patients with pathology-confirmed diagnosis of cHCC-CC who had undergone MRI and CT. This retrospective study includes nine patients (eight male, one female, mean age 54.8 years, range 42–70 years)who had either an hepatectomy (n=3) or a core biopsy (n=1) for HCC and CC, either a liver transplantation (LT) (n=5) for HCC. All the patients were evaluated with presurgical...

Histopathology The cHCC-CC is a "mixed" type in 6/9 patients and "combined" typein 3/9 patients. Serum markers The AFP serum level was elevated in 5/9 but only one up to 200 ng/mL and the CA19-9 serum level was elevated in 2/3 patient. These 2 patients have also an AFP serum level elavated. Morphologic imaging findings The cHCC-CC tumor presented as a single mass in allpatients, measuring from 1.5 to 10 cm on the axial plane (mean size 41 mm). All the cHCC-CC were 6/9 localized...

In conclusion, the imaging appearance of cHCC-CC is commonly a solitary mass, heterogeneous, hyperintense on T2-w in cirrhotic patients. In half of the case, after dynamic injection, cHCC-CC look likes HCC and the other half look like CC. This diagnosis could not be based on imaging alone. The combination of both elevated serum tumor markers may help in the diagnosis. The definitive diagnosis of cHCC-CC requires demonstration of both hepatocellular and cholangiocellulardifferentiation at histopathology analysis, which is usually facilitated by immunohistochemical and special stains to...

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Dr. Nicola Leo Radiology Hospital Paul Brousse Villejuif, Paris, FRANCE Email: [email protected] Special thanks to SIAD