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Combined Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma: Outcome After Liver Transplantation

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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

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Abbreviations

HCC:

Hepatocellular carcinoma

CC:

Cholangiocarcinoma

HCC-ICC:

Combined hepatocellular carcinoma and intrahepatic cholangiocarcinoma

LT:

Liver transplantation

AFP:

Alpha-fetoprotein

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Authors and Affiliations

  1. Department of Medicine, Division of Hepatology, University of Miami School of Medicine, Miami, FL, USA

    Kishore Maganty, Leopoldo Arosemena & Paul Martin

  2. Department of Surgery, Miami Transplant Institute, University of Miami School of Medicine, Miami, FL, USA

    David Levi, Jang Moon & Andreas Tzakis

  3. Department of Pathology, University of Miami School of Medicine, Miami, FL, 33136, USA

    Pablo A. Bejarano

  4. Department of Internal Medicine, Division of Gastroenterology, University of Kentucky Chandler Medical Center, 800 Rose Street, MN649, Lexington, KY, 40536-0298, USA

    Kishore Maganty

Authors
  1. Kishore Maganty
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  2. David Levi
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  3. Jang Moon
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  4. Pablo A. Bejarano
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  5. Leopoldo Arosemena
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  6. Andreas Tzakis
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  7. Paul Martin
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Correspondence to Kishore Maganty.

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Maganty, K., Levi, D., Moon, J. et al. Combined Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma: Outcome After Liver Transplantation. Dig Dis Sci 55, 3597–3601 (2010). https://doi.org/10.1007/s10620-010-1402-3

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  • DOI: https://doi.org/10.1007/s10620-010-1402-3

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