A Case of Malignant Mixed Tumor of the Liver in Adult with Hepatocellular Carcinoma

Hiroaki Saito, Hideaki Nishidoi, Akira Kondo, Minoru Ishiguro, Hirofumi Kudo, Satoshi Murakami, Tadao Masaki, Haruka Tamiguchi, Kouji Maeda

Department of Surgery, Tottori Red Cross Hospital

An extremely rare case of malignant mixed tumor of the liver in an adult with hepatocellular carcinoma is reported. A 74-year-old man was admitted with a liver tumor that had been discovered by ultrasound scanning in another hospital. Abdominal enchanced computed tomography (CT) revealed a well-circumscribed low density area with peripheral enhancement in the left lateral segment, and abdominal portal CT revealed shadow defects in the left lateral segment and the right anterior segment. Hepatic angiography revealed a hypervascular lesion with a tumor stain. Biopsies teken from the lesion in the left lateral segment showed cholangiocarcinoma, and in the right anterior segment showed hepatocellular carcinoma. Because of severe liver cirrhosis, subsegmentectomy was performed in the left anterior lateral segment, and percutaneous ethanol injection therapy was performed for the tumor in the right anterior segment after surgery. A macroscopic view of the resected specimen showed a white solitary tumor of 4.3×3.2 cm in size. Microscopic examination revealed that the tumor consisted of epithelial and mesenchymal elements. The mesenchymal cells were spindle shaped and proliferated over the whole tumor in which hepatocellular carcinoma and cholangiocarcinoma were scattered. The pathologic diagnosis was malignant mixed tumor of the liver in an adult with hepatocellular carcinoma. Twenty-four cases of malignant mixed tumor of the liver in adults reported in the Japanese literature were reviewed.

Key words
hepatocellular carcinoma, malignant mixed tumor of the liver

Reprint requests
Hiroaki Saito The First Department of Surgery, Tottori University, School of Medicine
86 Nishi-machi, Yonago City, 683 JAPAN

Accepted
July 10, 1996

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