Simultaneous occurrence of sarcomatoid hepatocellular carcinoma and hepatocellular carcinoma

Sarcomatoid hepatocellular carcinoma is a rare disease with a poor prognosis. A 62-year-old man presented with 1-month history of middle-grade fever and fatigue in the background of loss of weight and a history of hepatitis B for 10 years. Dynamic contrast enhanced computed tomography showed two distinct irregular hypodense masses on precontrast scan located in hepatic segment VI and VII with size 6.7×4.7×4.5 cm and 1.9×1.3×1.6 cm. The patient underwent the right hepatectomy. Microscopic examination revealed that the large tumor was sarcomatoid hepatocellular carcinoma and the small tumor was early hepatocellular carcinoma.