A CASE OF MIXED HEPATOCELLULAR AND CHOLANGIOCELLULAR CARCINOMA WHICH WAS INDISTINGUISHABLE FROM METASTASIS OF BREST CANCER

Abstract

A 59-year-old female was referred to the hospital because of a left breast tumor. On admission, laboratory findings revealed abnomality in her hepatic function and elevated levels of serum tumor markers such as AFP, CEA, CA19-9, DUPAN-2, CA15-3, TPA and CA12-5. HCV antibody was positive. The breast tumor was visualized as heterogenous tumor by ultrasonography which was suspected of primary breast cancer. Histological examination of the resected specimen indicated primary breast cancer. Abdominal ultrasonography and CT revealed an illdefined and low-absorbent tumor in the Seg5-8 and a well-defined and high-absorbent tumor in the Seg 8. These liver tumor presented difficulty in differential diagnosis from metastases of the breast cancer. The patient died of liver failure following rupture of esophageal varix. Autopsy revealed the cirrhotic liver with tumots, the tumors contained elements of both hepatocellular carcinoma and cholangiocellular carcinoma, and so the possible diagnosis of metastasis of the breast cancer was ruled out. A relatively rare case of combined hepatocellular and cholangiocellular carcinoma is reported.