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November 1, 2025American Journal of Clinical Pathology0 citationsOpen Access

280 A Fascinating Case of Combined Hepatocellular Carcinoma-Cholangiocarcinoma (cHCC-CCA) diagnosed on Liver Core Biopsy

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ELErnest LamMAMuhammed AwaisSCSatyapal Chahar

Key Points

  • This report aims to describe a rare case of combined hepatocellular-cholangiocarcinoma (cHCC-CCA).
  • Case report of a 66-year-old male patient with a liver mass diagnosed via image-guided biopsy.
  • Histologic analysis demonstrated two distinct populations of tumor cells.
  • Immunohistochemical staining was used to differentiate HCC and CCA features.
  • The tumor showed characteristics of both hepatocellular carcinoma and cholangiocarcinoma.
  • Histology revealed pleomorphism and distinct immunoprofiles for each tumor component.
  • Accurate diagnosis of cHCC-CCA is critical due to its worse prognosis.

Abstract

Abstract Introduction/Objective Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare primary hepatic malignancy accounting for 2-5% of primary liver carcinomas. cHCC-CCA is defined by presence of histologic features of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA). In this submission, we present an interesting case of cHCC-CCA and highlight the important features and significance of correctly diagnosing cHCC-CCA. Methods/Case Report We report an interesting case of cHCC-CCA in a 66-year-old male with a 5 cm targetoid mass in hepatic segment 8, suspicious for an atypical HCC. The patient underwent an image guided liver mass biopsy. H however, collision tumors are not part of this entity. Distant metastasis of this tumor can show either cHCC-CCA features or any individual component of the combined tumor. Correct diagnosis of cHCC-CCA is of utmost importance given that cHCC-CCA has a worse prognosis and different clinical follow-up pattern than a conventional HCC. As cHCC-CCA are treated clinically as a more aggressive tumor along the lines of the CCA component so we should always keep this rare diagnosis in our mind when examining the liver neoplastic biopsies.

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Cite This Study

Lam et al. (2025) studied this question.

synapsesocial.com/papers/69254371c0ce034ddc3587eehttps://doi.org/10.1093/ajcp/aqaf121.319
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