Hepatocellular carcinoma with sarcomatous proliferation showing an unusual and wide-spread metastasis

A hepatoma comprised of carcinomatous and sarcomatous proliferation has been considered as collision or carcinoma with sarcomatous proliferation. In this report, an autopsy case of primary hepatocellular carcinoma showing almost equal amount of carcinomatous and sarcomatous proliferations is presented. Serial sections from the tumor showed the frequent transition of the figure from carcinoma to sarcoma, justifying the diagnosis of hepatocellular carcinoma with sarcomatous proliferation. When compared with the usual hepatocellular carcinoma, metastasis with sarcomatous figure was more extensive and both ventricles and atriums of the heart, skin, and intestinal tract were involved. A sarcomatous proliferation in hepatocellular carcinoma and manner of metastasis are discussed with a review of the pertinent literature.