Synchronous development of intrahepatic cholangiocarcinoma and hepatocellular carcinoma in different sites of the liver with chronic B-viral hepatitis: two case reports

BMC Research Notes

Jun Yong Park³  Young Nyun Park³  Hye Sun Shin¹  Hyae Min Jeon²  Gi Hong Choi³  Kyeong Hyeon Chun¹  Kyu Sik Jung¹ 

[1] Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun–gu, Seoul 120-752, Korea;Department of Pathology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun–gu, Seoul 120-752, Korea;Liver Cancer Special Clinic, Severance Hospital, 50 Yonsei-ro, Seodaemun–gu, Seoul 120-752, Korea

关键词: Chronic liver disease;    Hepatitis B virus;    Double primary liver cancer;    Intrahepatic cholangiocarcinoma;    Hepatocellular carcinoma;   

Others  :  1140538
DOI  :  10.1186/1756-0500-6-520

 received in 2012-11-16, accepted in 2013-12-03,  发布年份 2013

【 摘 要 】

Background

Synchronous development of primary hepatocellular carcinoma and intrahepatic cholangiocarcinoma has been reported rarely. In literature review, there have been only 35 reported cases of synchronous hepatocellular carcinoma and intrahepatic cholangiocarcinoma, and most of these tumors developed in patients with hepatitis C-related liver cirrhosis. Here, we present synchronous development of hepatocellular carcinoma and intrahepatic cholangiocarcinoma in two patients with chronic B-viral hepatitis.

Case presentation

Two patients with chronic hepatitis B were referred to our hospital due to a hepatic mass. Patient 1 had a 6.4 cm multinodular hepatic mass in the left lobe and a small nodule in the right lobe. Patient 2 had a 4.3 cm hypervascular mass in the right lobe and a 1.1 cm nodule in the left lobe. The pre-operative diagnosis of both cases was hepatocellular carcinoma with metastatic nodule, however, surgical resection pathology revealed that hepatocellular carcinoma and intrahepatic cholangiocarcinoma existed independently in the other side of the liver in both cases. Additionally, the background liver histology of both cases was hepatitis B-related chronic hepatitis without cirrhotic change.

Conclusion

Our cases suggest that hepatitis B virus infection can also predispose to development of double liver cancers.

【 授权许可】

   
2013 Jung et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Fuji N, Taniguchi H, Amaike H, Oka K, Tsuchihashi Y, Urasaki K, Naito K: Synchronously resected double primary hepatic cancer, hepatocellular carcinoma and cholangiocarcinoma. J Gastroenterol Hepatol 2005, 20:967-969.
• [2]Matsuda M, Hara M, Suzuki T, Kono H, Fujii H: Synchronously resected double primary hepatic cancers - hepatocellular carcinoma and cholangiolocellular carcinoma. J Hepatobiliary Pancreat Surg 2006, 13:571-576.
• [3]Inaba K, Suzuki S, Sakaguchi T, Kobayasi Y, Takehara Y, Miura K, Baba S, Nakamura S, Konno H: Double primary liver cancer (intrahepatic cholangiocarcinoma and hepatocellular carcinoma) in a patient with hepatitis C virus-related cirrhosis. J Hepatobiliary Pancreat Surg 2007, 14:204-209.
• [4]Watanabe T, Sakata J, Ishikawa T, Shirai Y, Suda T, Hirono H, Hasegawa K, Soga K, Shibasaki K, Saito Y, Umezu H: Synchronous development of HCC and CCC in the same subsegment of the liver in a patient with type C liver cirrhosis. World J Hepatol 2009, 1:103-109.
• [5]Kwon Y, Lee SK, Kim JS, Ro JY, Yu E: Synchronous hepatocellular carcinoma and cholangiocarcinoma arising in two different dysplastic nodules. Mod Pathol 2002, 15:1096-1101.
• [6]Kim YW, Park YK, Park JH, Lee J, Lee SM, Hong SW, Yang MH: A case with intrahepatic double cancer: hepatocellular carcinoma and cholangiocarcinoma associated with multiple von Meyenburg complexes. Yonsei Med J 1999, 40:506-509.
• [7]Yoshida H, Shiratori Y, Moriyama M, Arakawa Y, Ide T, Sata M, Inoue O, Yano M, Tanaka M, Fujiyama S, Nishiquchi S, Kuroki T, Imazeki F, Yokosuka O, Kinoyama S, Yamada G, Omata M: Interferon therapy reduces the risk for hepatocellular carcinoma: national surveillance program of cirrhotic and noncirrhotic patients with chronic hepatitis C in Japan. IHIT Study Group. Inhibition of Hepatocarcinogenesis by Interferon Therapy. Ann Intern Med 1999, 131:174-181.
• [8]Kobayashi M, Ikeda K, Saitoh S, Suzuki F, Tsubota A, Suzuki Y, Arase Y, Murashima N, Chayama K, Kumada H: Incidence of primary cholangiocellular carcinoma of the liver in japanese patients with hepatitis C virus-related cirrhosis. Cancer 2000, 88:2471-2477.
• [9]Llovet JM, Burroughs A, Bruix J: Hepatocellular carcinoma. Lancet 2003, 362:1907-1917.
• [10]Lee TY, Lee SS, Jung SW, Jeon SH, Yun SC, Oh HC, Kwon S, Lee SK, Seo DW, Kim MH, Suh DJ: Hepatitis B virus infection and intrahepatic cholangiocarcinoma in Korea: a case–control study. Am J Gastroenterol 2008, 103:1716-1720.
• [11]Komuta M, Govaere O, Vandecaveye V, Akiba J, Van Steenbergen W, Verslype C, Laleman W, Pirenne J, Aerts R, Yano H, Nevens F, Topal B, Roskams T: Histological diversity in cholangiocellular carcinoma reflects the different cholangiocyte phenotypes. Hepatology 2012, 55:1876-1888.
• [12]Lee CH, Chang CJ, Lin YJ, Yeh CN, Chen MF, Hsieh SY: Viral hepatitis-associated intrahepatic cholangiocarcinoma shares common disease processes with hepatocellular carcinoma. Br J Cancer 2009, 100:1765-1770.
• [13]Komuta M, Spee B, Vander Borght S, De Vos R, Verslype C, Aerts R, Yano H, Suzuki T, Matsuda M, Fujii H, Desmet VJ, Kojiro M, Roskams T: Clinicopathological study on cholangiolocellular carcinoma suggesting hepatic progenitor cell origin. Hepatology 2008, 47:1544-1556.
• [14]Kumar M, Zhao X, Wang XW: Molecular carcinogenesis of hepatocellular carcinoma and intrahepatic cholangiocarcinoma: one step closer to personalized medicine? Cell Biosci 2011, 1:5. BioMed Central Full Text
• [15]Alison MR, Lovell MJ: Liver cancer: the role of stem cells. Cell Prolif 2005, 38:407-421.
• [16]Roskams T: Liver stem cells and their implication in hepatocellular and cholangiocarcinoma. Oncogene 2006, 25:3818-3822.
• [17]Pungpapong S, Kim WR, Poterucha JJ: Natural history of hepatitis B virus infection: an update for clinicians. Mayo Clin Proc 2007, 82:967-975.
• [18]Lee KS, Kim DJ: Management of chronic hepatitis B. Korean J Hepatol 2007, 13:447-488.
• [19]Liu CJ, Kao JH: Hepatitis B virus-related hepatocellular carcinoma: epidemiology and pathogenic role of viral factors. J Chin Med Assoc 2007, 70:141-145.
• [20]Peng NF, Li LQ, Qin X, Guo Y, Peng T, Xiao KY, Chen XG, Yang YF, Su ZX, Chen B, Su M, Qi LN: Evaluation of risk factors and clinicopathologic features for intrahepatic cholangiocarcinoma in Southern China: a possible role of hepatitis B virus. Ann Surg Oncol 2011, 18:1258-1266.
• [21]Zhou YM, Yin ZF, Yang JM, Li B, Shao WY, Xu F, Wang YL, Li DQ: Risk factors for intrahepatic cholangiocarcinoma: a case–control study in China. World J Gastroenterol 2008, 14:632-635.
• [22]Li M, Li J, Li P, Li H, Su T, Zhu R, Gong J: Hepatitis B virus infection increases the risk of cholangiocarcinoma: a meta-analysis and systematic review. J Gastroenterol Hepatol 2012, 27:1561-1568.
• [23]Bruix J, Sherman M: Management of hepatocellular carcinoma: an update. Hepatology 2011, 53:1020-1022.
• [24]Zhou H, Wang H, Zhou D, Wang Q, Zou S, Tu Q, Wu M, Hu H: Hepatitis B virus-associated intrahepatic cholangiocarcinoma and hepatocellular carcinoma may hold common disease process for carcinogenesis. Eur J Cancer 2010, 46:1056-1061.
• [25]Cardinale V, Carpino G, Reid L, Gaudio E, Alvaro D: Multiple cells of origin in cholangiocarcinoma underlie biological, epidemiological and clinical heterogeneity. World J Gastrointest Oncol 2012, 4:94-102.