Hepatic recurrence of cholangiolocellular carcinoma: report of a case

We present a rare case of hepatic recurrence of cholangiolocellular carcinoma in a 61-year-old woman. The patient's past history included a right hepatic lobectomy and a hepatic hilar resection with hepaticojejunostomy for cholangiolocelluar carcinoma in 1990. After the diagnosis of hepatic recurrence in 1993, a partial hepatic resection was performed. The gross specimen showed an irregularly shaped white nodular tumor 2.5 cm in size without liver cirrhosis. The histopathological findings revealed small cuboidal cells resembling cholangiole forming acinar structures with fibrotic stroma, these findings were the same as those in the previously resected tumor. An immunohistochemical examination showed a positive reaction to carcinoembryonic antigen and keratin. The ultrastructural features revealed small round nuclei, flat contact of the cell membranes without interdigitation resembling that of hepatocytes, relatively numerous intracytoplasmic filaments, few organelae and a basement membrane resembling those of the bile duct epithelium. No recurrence has been observed during a one-year follow up. On the basis of the characteristic clinical and histopathological features of this case, we therefore consider that cholangiolocellular carcinoma should be recognized as an intermediate type somewhere between hepatocellular and cholangiocellular carcinoma.