Primary undifferentiated carcinoma with osteoclast-like giant cells in liver and rapidly developing multiple metastases after curative hepatectomy: a case report.

Abstract

A 64-year-old man was diagnosed with cholangiocellular carcinoma based on preoperative computed tomography and magnetic resonance imaging and underwent laparoscopic segmentectomy (Segment 8) of the liver for radical operation. Pathological examination revealed the presence of an undifferentiated carcinoma with osteoclast-like giant cells, which were categorized as T3N0M0 and Stage III based on the third English edition of the Japanese classification of liver cancer. The patient was treated with three courses of combination chemotherapy, which included gemcitabine (1000mg/m2) and cisplatin (25mg/m2), as well as S-1 (120mg/day) for adjuvant chemotherapy. At two months after the operation, CT revealed multiple liver- and lung metastases. Thereafter, the patient was prescribed the molecularly targeted drug, lenvatinib (12mg/day). However, lenvatinib was not effective, as evident by the extension of several metastases. Testing for microsatellite instability was negative. The patient died 5months after the operation. We experienced a case of primary undifferentiated carcinoma with osteoclast-like giant cells in the liver showed rapidly developing multiple metastases after curative liver resection.