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[Sarcomatous hepatocellular carcinoma]

T Mirejovský¹, P Mirejovský

¹Hlavův I. patologickoanatomický ústav 1. LF UK a VFN, Praha.

Ceskoslovenska Patologie

|March 21, 1998

Summary

Atypical hepatocellular carcinoma with a sarcomatoid pattern presents diagnostic challenges. This rare variant, seen in two elderly patients, shows mixed epithelial and mesenchymal markers on immunohistochemistry.

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Area of Science:

Oncology
Pathology
Gastroenterology

Background:

Atypical liver carcinomas can be diagnostically challenging compared to classical types.
Hepatocellular carcinoma (HCC) is the most common primary liver cancer.

Observation:

Two elderly patients presented with large, unusual hepatocellular carcinoma exhibiting a sarcomatoid pattern.
Immunohistochemical analysis revealed coexpression of epithelial and mesenchymal markers.

Findings:

Case 1: Positive for cytokeratin, actin, and desmin.
Case 2: Positive for cytokeratin, chromogranin, and actin.
Both cases showed positivity for epithelial membrane antigen (EMA) and alpha-1-antitrypsin (A1AT).

Implications:

Sarcomatoid HCC is a rare variant, estimated at 4% of all HCC cases.
Recognizing this pattern is crucial for accurate diagnosis and appropriate patient management.
Coexpression of markers aids in differentiating sarcomatoid HCC from other tumors.

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