Primary carcinosarcoma of the liver: imaging features and clinical findings in six cases and a review of the literature
Abstract Background Carcinosarcoma of the liver is a very rare tumor composed of a mixture of carcinomatous and sarcomatous elements. Less than 25 adequately documented cases have been reported, with inadequate description of imaging features. In order to improve the awareness of this rare tumor, th...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-02-01
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| Series: | Cancer Imaging |
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| Online Access: | http://link.springer.com/article/10.1186/s40644-018-0141-0 |
| _version_ | 1818939769974947840 |
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| author | Jing Li Pan Liang Dandan Zhang Jie Liu Hongkai Zhang Jinrong Qu Jianbo Gao |
| author_facet | Jing Li Pan Liang Dandan Zhang Jie Liu Hongkai Zhang Jinrong Qu Jianbo Gao |
| author_sort | Jing Li |
| collection | DOAJ |
| description | Abstract Background Carcinosarcoma of the liver is a very rare tumor composed of a mixture of carcinomatous and sarcomatous elements. Less than 25 adequately documented cases have been reported, with inadequate description of imaging features. In order to improve the awareness of this rare tumor, this study aimed to analyze the clinicopathologic and imaging features of six cases of hepatic carcinosarcoma (HCS) confirmed by surgical pathologic evaluation. Methods We retrospectively studied the clinicopathologic and imaging features of six cases of HCS (matching the World Health Organization definition) and discussed the differential diagnosis on the basis of imaging findings. The patients, including five men and one woman, were 38 to 69 years of age. Five patients underwent CT scans, one underwent MRI scans. Results While 3 patients were positive for hepatitis-B surface antigen, 2 had cirrhosis. The largest tumor diameter ranged from 5.0 to 21.0 cm. Satellite nodules, venous thrombi, and organ invasion (gastric wall, gallbladder, and right adrenal gland) were identified. Pathologically, the carcinomatous components corresponded to hepatocellular carcinoma in three cases, cholangiocellular carcinoma in one case, and adenocarcinoma in two cases. The sarcomatous components exhibited complex features, with undifferentiated spindle cells in five cases and a leiomyosarcoma in one. All tumors showed heterogeneous density/intensity with extensive cystic change and necrosis; spot calcification was observed in one case. Capsule was not identified. While four tumors showed heterogeneous hypervascular enhancement, two showed hypovascular enhancement. All patients underwent surgical resection. The follow-up period ranged from 2 to 18 months. Four patients died from recurrence and metastasis. Conclusions The clinical and imaging features of HCS are heterogeneous. Due to the heterogenous nature and very low morbidity of HCS, combination of careful analysis of imaging findings and clinical features might be useful for a more accurate diagnosis of HCS. |
| first_indexed | 2024-12-20T06:29:01Z |
| format | Article |
| id | doaj.art-04245970d67b49e3b1a215722b471a5b |
| institution | Directory Open Access Journal |
| issn | 1470-7330 |
| language | English |
| last_indexed | 2024-12-20T06:29:01Z |
| publishDate | 2018-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer Imaging |
| spelling | doaj.art-04245970d67b49e3b1a215722b471a5b2022-12-21T19:50:11ZengBMCCancer Imaging1470-73302018-02-0118111310.1186/s40644-018-0141-0Primary carcinosarcoma of the liver: imaging features and clinical findings in six cases and a review of the literatureJing Li0Pan Liang1Dandan Zhang2Jie Liu3Hongkai Zhang4Jinrong Qu5Jianbo Gao6Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer HospitalDepartment of Radiology, the First Affiliated Hospital of Zhengzhou UniversityDepartment of Pathology, the First Affiliated Hospital of Zhengzhou UniversityDepartment of Radiology, the First Affiliated Hospital of Zhengzhou UniversityDepartment of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer HospitalDepartment of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer HospitalDepartment of Radiology, the First Affiliated Hospital of Zhengzhou UniversityAbstract Background Carcinosarcoma of the liver is a very rare tumor composed of a mixture of carcinomatous and sarcomatous elements. Less than 25 adequately documented cases have been reported, with inadequate description of imaging features. In order to improve the awareness of this rare tumor, this study aimed to analyze the clinicopathologic and imaging features of six cases of hepatic carcinosarcoma (HCS) confirmed by surgical pathologic evaluation. Methods We retrospectively studied the clinicopathologic and imaging features of six cases of HCS (matching the World Health Organization definition) and discussed the differential diagnosis on the basis of imaging findings. The patients, including five men and one woman, were 38 to 69 years of age. Five patients underwent CT scans, one underwent MRI scans. Results While 3 patients were positive for hepatitis-B surface antigen, 2 had cirrhosis. The largest tumor diameter ranged from 5.0 to 21.0 cm. Satellite nodules, venous thrombi, and organ invasion (gastric wall, gallbladder, and right adrenal gland) were identified. Pathologically, the carcinomatous components corresponded to hepatocellular carcinoma in three cases, cholangiocellular carcinoma in one case, and adenocarcinoma in two cases. The sarcomatous components exhibited complex features, with undifferentiated spindle cells in five cases and a leiomyosarcoma in one. All tumors showed heterogeneous density/intensity with extensive cystic change and necrosis; spot calcification was observed in one case. Capsule was not identified. While four tumors showed heterogeneous hypervascular enhancement, two showed hypovascular enhancement. All patients underwent surgical resection. The follow-up period ranged from 2 to 18 months. Four patients died from recurrence and metastasis. Conclusions The clinical and imaging features of HCS are heterogeneous. Due to the heterogenous nature and very low morbidity of HCS, combination of careful analysis of imaging findings and clinical features might be useful for a more accurate diagnosis of HCS.http://link.springer.com/article/10.1186/s40644-018-0141-0LiverCarcinosarcomaTomographyX-ray computedMagnetic resonance imagingDiagnosis |
| spellingShingle | Jing Li Pan Liang Dandan Zhang Jie Liu Hongkai Zhang Jinrong Qu Jianbo Gao Primary carcinosarcoma of the liver: imaging features and clinical findings in six cases and a review of the literature Cancer Imaging Liver Carcinosarcoma Tomography X-ray computed Magnetic resonance imaging Diagnosis |
| title | Primary carcinosarcoma of the liver: imaging features and clinical findings in six cases and a review of the literature |
| title_full | Primary carcinosarcoma of the liver: imaging features and clinical findings in six cases and a review of the literature |
| title_fullStr | Primary carcinosarcoma of the liver: imaging features and clinical findings in six cases and a review of the literature |
| title_full_unstemmed | Primary carcinosarcoma of the liver: imaging features and clinical findings in six cases and a review of the literature |
| title_short | Primary carcinosarcoma of the liver: imaging features and clinical findings in six cases and a review of the literature |
| title_sort | primary carcinosarcoma of the liver imaging features and clinical findings in six cases and a review of the literature |
| topic | Liver Carcinosarcoma Tomography X-ray computed Magnetic resonance imaging Diagnosis |
| url | http://link.springer.com/article/10.1186/s40644-018-0141-0 |
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