A Patient's Journey With Rare Biphenotypic Hepatocellular Carcinoma and Cholangiocarcinoma

Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare neoplastic primary liver cancer that is also known as mixed HCC-CC since it portrays characteristics of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). It constitutes less than 5% of primary liver cancers, hence, the literature lacks guidance on the management of these patients. A handful of case series has been published on clinical features and surgical outcomes. There is next-to-no mention of how to treat these patients. However, surgery has proven the most definitive treatment with varied responses to systemic therapies. We present a case of cHCC-CC in a patient who has undergone multiple treatment modalities, including surgical resection, chemotherapy, immunotherapy, and targeted therapy.