Primary Carcinosarcoma of the Liver: Clinicopathologic Features of 5 Cases and a Review of the Literature

作者：Xiang‐Ming Lao, Dongying Chen, Ya-Qi Zhang, Jin Xiang, Rong Guo, Xiao-Jun Lin, Jin-Qing Li · 发表于：The American Journal of Surgical Pathology · 年份：2007 · DOI：10.1097/01.pas.0000213431.07116.e0 · 被引用次数：80 · 研究领域：Metastasis and carcinoma case studies、Cholangiocarcinoma and Gallbladder Cancer Studies、Cancer Diagnosis and Treatment

Carcinosarcoma of the liver is very rare worldwide. The terminology and pathogenesis of hepatic carcinosarcoma remain controversial issues. In this article, we studied the clinicopathologic features of 5 cases of hepatic carcinosarcomas (matching the World Health Organization definition), analyzed the clinical data, histologic and immunohistochemical (IHC) results, and discussed the terminology, pathologic differential diagnoses, pathogenesis, and prognosis. The patients were 40 to 68 years old, and included 4 males and 1 female. All patients were Hepatitis B surface antigen positive with para-tumorous cirrhosis. The largest dimensions of the neoplasms ranged from 6.0 to 14.0 cm. Satellite nodules, portal vein tumor thrombi, direct invasion into local tissues (right diaphragm, right adrenal gland, and gastric wall) as well as metastatic foci in lungs and abdominal lymph nodes were identified. Pathologically, the neoplasms consisted of carcinomatous and sarcomatous components. The carcinomatous components were exclusively conventional hepatocellular carcinomas in all 5 cases, whereas the sarcomatous components exhibited complex features. Confirmed by IHC studies, the sarcomatous elements in different cases included rhabdomyosarcomas, malignant fibrous histiocytomas, fibrosarcoma, and poorly differentiated spindle cells without distinctive differentiation. Furthermore, the sarcomatous elements in these 5 neoplasms stained negative for all the epithelial markers we applied for I...