Keywords:
Abdomen, Liver, Contrast agents, MR, CT, Ultrasound, Chemoembolisation, Neoplasia, Pathology
Authors:
N. Leo, C. E. Balasa, S. Bivol, Z. Dhina-Louison, L. Ricca, E. Vibert, M. Lewin; Villejuif/FR
DOI:
10.1594/ecr2013/C-2582
Purpose
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 recently,
cHCC-CC is considered as a distinct type of primary liver carcinoma,
which is morphologically and phenotypically intermediate between HCC and CC and may be derived from hepatic progenitor cells with the bipotential to differentiate into both hepatocytic and cholangiocytic lineages.
(Kim et al.
in 2004 and Zhang et al.
in 2008)
The actual incidence of cHCC-CC is not known,
ranging substantially between studies and geographical region,
with greater numbers reported in Asia.
Most of the studies suggested that cHCC-CCs are more commonly diagnosed in patients with chronic hepatitis and liver cirrhosis,
with a conspicuous male predominance.
On imaging,
the diagnosis of cHCC-CC is problematic with the diagnosis established in the great majority of cases in the postsurgical period,
when the most important therapeutic decisions have already been made. Cases are very often misdiagnosed as HCC or CC in the initial evaluation. This misinterpretation may have therapeutic implications,
since treatment may differ significantly from that of HCC or CC alone.
To clarify the imaging features of combined hepatocellular and cholangiocarcinomas (cHCC-CC) in comparison with hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) imaging,
in a retrospective study of patients undergoing hepatectomy,
core biosy and liver transplantation (LT).