Primary Carcinosarcoma of the Liver

초록

Background: Primary hepatic carcinosarcoma is a very rare tumor. About 60 cases have been reported in the English literature. Most cases consist of hepatocellular carcinoma with 1 to 2 sarcomatous component. Case Report: We report a case of 70-year-old man with primary carcinosarcoma of the liver, consisting of 2 carcinomatous components and various sarcomatous components. The patient was a heavy alcoholics and viral markers were negative. Alpha fetoprotein and PIVKA were markedly increased. The resected tumor revealed intrahepatic and exophytic components, totally measuring 24×9×8cm. Microscopically, both carcinomatous and sarcomatous components were intermingled in the liver but the exophytic portion showed sarcomatous overgrowth. The carcinomatous component was composed of hepatocellular carcinoma in majority and combined hepatocellular-cholangiocarcinoma with stem cell feature, intermediated type, focally. The sarcomatous element composed of osteosarcoma, leiomyosarcoma, chondrosarcma and poorly differentiated high grade sarcoma. Conclusion: Suggested pathogenetic mechanisms are metaplasia, transformation, and epithelial-mesenchymal transition. Prognosis of the carcinosarcoma of the liver is poor. Key Words: Carcinosarcom, Liver, Hepatocellular carcinoma, Osteosarcoma