Digestive Diseases and Sciences

, Volume 55, Issue 12, pp 3597–3601 | Cite as

Combined Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma: Outcome After Liver Transplantation

  • Kishore Maganty
  • David Levi
  • Jang Moon
  • Pablo A. Bejarano
  • Leopoldo Arosemena
  • Andreas Tzakis
  • Paul Martin
Original Article



Combined hepatocellular carcinoma and intrahepatic cholangiocarcinoma is a rare hepatobiliary malignancy incorporating components derived from both hepatocyte and intrahepatic bile duct epithelium. The natural history, treatment, and prognosis of this distinct cancer differ from hepatocellular carcinoma (HCC) or cholangiocarcinoma (CC) and are not completely understood. There is considerable controversy about the classification, treatment, and survival, which in turn is related to the rarity of the condition. Treatment options include surgical resection and the prognosis is believed to be better than CC but worse than HCC alone.


We report a single-center liver transplantation experience with the management of three patients with combined HCC-ICC with LT. Two patients were transplanted with presumed HCC within Milan criteria and the other patient was noted to have an incidental nodule in the explanted liver. Histomorphology and immunohistochemical studies revealed the presence of combined HCC-ICC in all three explants.


One patient died 144 days after LT due to metastatic tumor. The second patient is alive and is tumor free at 8.5 years post-LT, and the third patient died of metastatic tumor at 155 days after LT.


Good long-term survival can be achieved in at least some patients with this combined tumor type.


Hepatocellular carcinoma Cholangiocarcinoma Liver transplantation Combined hepatocellular carcinoma and intrahepatic cholangiocarcinoma 



Hepatocellular carcinoma




Combined hepatocellular carcinoma and intrahepatic cholangiocarcinoma


Liver transplantation




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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Kishore Maganty
    • 1
    • 4
  • David Levi
    • 2
  • Jang Moon
    • 2
  • Pablo A. Bejarano
    • 3
  • Leopoldo Arosemena
    • 1
  • Andreas Tzakis
    • 2
  • Paul Martin
    • 1
  1. 1.Department of Medicine, Division of HepatologyUniversity of Miami School of MedicineMiamiUSA
  2. 2.Department of Surgery, Miami Transplant InstituteUniversity of Miami School of MedicineMiamiUSA
  3. 3.Department of PathologyUniversity of Miami School of MedicineMiamiUSA
  4. 4.Department of Internal Medicine, Division of GastroenterologyUniversity of Kentucky Chandler Medical CenterLexingtonUSA

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