A case with sarcomatoid hepatocellular carcinoma and literature review

Abstract

Sarcomatoid hepatocellular carcinoma (SHC) is a relatively rare subtype of liver cancer reported in 1.8–2.0% of surgically resected cases. Previous studies have found that SHC was more likely to occur in patients who received repeated anticancer therapies, but the underlying mechanism has not been exactly illustrated. We report a case of a 62-year-old man with SHC. With the initial implication of abscess suspected liver mass by radiological exams (enhanced Computed Tomography and liver Magnetic Resonance Imaging), the patient underwent a laparoscopic pus debridement and biopsy. The diagnosis of SHC was considered by pathologists. After a short recovery, a second radical resection of the liver tumor and hepatic hilar lymph node dissection were conducted. Postoperative pathology revealed a tumor-free incisal margin and negative lymph node. The recovery of the patient was uneventful. When confronting an occasional liver mass with previous Hepatitis B virus infection, SHC should be included for a candidate diagnosis. If diagnosis is confirmed, high biological malignancy and poor survival should be expected. Surgery is still a main option to treat SHC.