Pathological changes of a malignant liver tumor after systemic therapies

Systemic therapeutic regimens for malignant tumors are usually determined on the basis of the pathologic diagnosis. Patients usually undergo later-line regimens for the same tumor pathology without re-biopsy when they experience progressive disease (PD). In this report, we describe a patient with a malignant liver tumor in which the pathology transformed from intrahepatic cholangiocarcinoma (ICC) to hepatocellular carcinoma (HCC) after a partial response and PD following systemic therapies for ICC. The patient maintained stable disease with a regimen for HCC after PD following the ICC regimen. This case showed the possible transformation of tumor pathologic features with systemic therapies. The results suggest the potential necessity to reconfirm the pathologic features of malignant liver tumors when patients experience PD after a response to systemic therapies.