Table 1 Summarized data on published reports concerning ICC with sarcomatous change
Author | Year | Age (years)/ Gender | Tumor location | Tumor size (cm) | Plain CT | Enhancement CT | T1WI | T2WI | Treatment | Carcinomatous component | Sarcomatous component | Distribution | Transitional feature | IHC of carcinomatous component | IHC of sarcomatous component | Preoperative diagnosis |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Sasaki et al. [13] | 1991 | 79/M | Left lobe | 8 | ND | ND | ND | ND | None | Adenosquamous carcinoma | Spindle and pleomorphic cells | ND | ND | Keratin+, EMA+, | Vim+ | ND |
Haratake et al. [14] | 1992 | 59/M | Left lobe | Fist-sized | ND | ND | ND | ND | None | Poorly adenocarcinoma | Spindle cells | Intermingled | ND | EMA+, CEA+, CK+ | Vim+ | Liver abscess |
Nakajima et al. [15] | 1993 | 84/F | Hepatic hilum | 3.5 | ND | ND | ND | ND | None | Moderately adenocarcinoma | Spindle and pleomorphic cells | Intermingled | + | Keratin+, EMA+ | Keratin+, EMA+, CA19-9+ | ND |
43/F | Right lobe | 14 | ND | ND | ND | ND | Right lobectomy | Moderately adenocarcinoma | Spindle cells | Intermingled | + | Keratin+, EMA+ | Keratin+, EMA+, Vim+ | ND | ||
73/F | Left lobe | 7 | ND | ND | ND | ND | Anti-cancer chemotherapy | Moderately adenocarcinoma | Spindle and pleomorphic cells | Intermingled | + | Keratin+, EMA+ | None | ND | ||
37/M | Left lobe | 10 | ND | ND | ND | ND | None | Moderately adenocarcinoma | Spindle and pleomorphic cells | Intermingled | + | Keratin+, EMA+ | Keratin+, EMA+, Vim+ | ND | ||
64/M | Left lobe | 7.5 | ND | ND | ND | ND | TAE | Poorly adenocarcinoma | Spindle and pleomorphic cells | Intermingled | + | Keratin+, EMA+ | Keratin+, EMA+ | ND | ||
52/M | Right lobe | 7.5 | ND | ND | ND | ND | TAE | Poorly adenocarcinoma | Spindle and pleomorphic cells | Intermingled | + | Keratin+, EMA+ | Keratin+, EMA+, CEA+ | ND | ||
69/M | Left lobe | 10 | ND | ND | ND | ND | Left lobectomy | Poorly adenocarcinoma | Spindle cells | Intermingled | + | Keratin+, EMA+ | None | ND | ||
Imazu et al. [16] | 1995 | 77/M | Segment 2 | 6 | Low density | Ring enhancement | Low intensity | Low intensity | Lateral segmentectomy | Glandular formation | Spindle cells | Intermingled | ND | Keratin+, CEA+, Vim+, | Keratin+, CEA+, Vim+, | ICC |
Honda et al. [17] | 1996 | 61/F | Right lobe | Numerous variously sized | ND | ND | ND | ND | None | Moderately to poorly adenocarcinoma | Rhabdoid cells | Separated (intermingled at the border) | + | Keratin+ | Keratin+, CEA-, Vim+ | ICC with peritonitis carcinomatosa |
Matsuo et al. [18] | 1999 | 77/F | Left lobe | 7.7 | Low density | Ring enhancement | Iso- to low intensity | Heterogeneous high and low intensity | Left lobectomy | Moderately to poorly adenocarcinoma | Spindle cells | Intermingled | + | EMA+, CK+, CEA+ | Vim+, Epithelial markers- | Liver abscess |
Itamoto et al. [19] | 1999 | 70/M | Segment 5/6 | 10.7 | Low density | Poor | ND | ND | Right lobectomy | Moderately adenocarcinoma | Spindle cells | Intermingled | + | CA19-9+, EMA+ Keratin+, Vim- | Keratin+, EMA+, Vim-H | Recurrent HCC |
Shimada et al. [20] | 2000 | 70/M | Segment 5 | 3.4 | ND | ND | ND | ND | Central bisegmentectomy | Poorly adenocarcinoma | Spindle cells | Intermingled | + | EMA+, Keratin+, CEA+, Vim+ | EMA+, Keratin+, Vim+ | ND |
55/M | Segment 7/8 | 6.7 | ND | ND | ND | ND | Partial hepatectomy | Moderately to poorly adenocarcinoma | Spindle and pleomorphic cells | Intermingled | + | EMA+, Keratin+ | EMA+, Keratin+, Vim+ | ND | ||
74/F | Segment 8 | 4.0 | ND | ND | ND | ND | Right lobectomy | Poorly adenocarcinoma | Spindle cells | Intermingled | + | EMA+, Keratin+, CEA+, Vim+ | EMA+, Keratin+, CEA+, Vim+ | ND | ||
64/F | Segment 4 | 8.0 | ND | ND | ND | ND | Left trisegmentectomy | Moderately to poorly adenocarcinoma | Spindle cells | Intermingled | + | EMA+, Keratin+, CEA+, CA19-9+,AFP+, Vim+ | EMA+, Keratin+, CEA+, CA19-9+, Vim+ | ND | ||
Kaibori et al. [21] | 2003 | 69/F | Lateral segment | 20 | Low density | Ring enhancement | ND | ND | Lateral segmentectomy | Moderately adenocarcinoma | Spindle and pleomorphic cells | Intermingled | + | ND | Vim+, EMA+, CK+ | Leiomyosarcoma |
Sato et al. [22] | 2006 | 87/M | Left lobe | 4.0 | ND | ND | ND | ND | None | Moderately adenocarcinoma | Round cells | Intermingled | ND | CK7+, CK19+, CAM5.2+, CA19-9+ | CK7+, CK19+, CAM5.2+, Vim+ | ICC |
Tsou et al. [23] | 2008 | 69/F | Left lobe | 2.5 | Low density | Ring enhancement | ND | ND | Segmentectomy | Well to moderately adenocarcinoma | Spindle and pleomorphic cells | Intermingled | ND | ND | CK7+, Vim+ | ND |
Malhotra et al. [24] | 2010 | 60/F | Segment 5 | 20 | ND | Heterogeneous mass | ND | ND | Lateral segmentectomy | Moderately adenocarcinoma | Pleomorphic spindle cells | Intermingled | ND | CAM5.2, EMA+, AE1/AE3+, CK7+, CK19+, CEA+ | Vim+, Epithelial markers- | ND |
Inoue et al. [25] | 2012 | 61/M | Left lateral segment | 20 | Heterogeneous mass | Ring enhancement | ND | ND | Lateral segmentectomy | Moderately adenocarcinoma | ND | ND | + | CK7+, CK19+ | Vim+, Keratin-1+ | GIST |
Nakajima et al. [26] | 2012 | 77/F | Right lobe | 14 | Low density | Heterogeneous enhancement | Low intensity | Iso- to high intensity | Right hepatic trisegmentectomy and caudate lobectomy | Moderately adenocarcinoma | Spindle cells and chondrosarcomatous change | Intermingled | Â | AE1+ | Vim+, Keratin- | CCC or cystadenocarcinoma |
Watanabe et al. [27] | 2014 | 62/M | Hepatic hilum | 5.0 | Low density | Ring enhancement | ND | ND | Extended right hemihepatectomy | Moderately to poorly adenocarcinoma | Spindle and pleomorphic cells | Intermingled | ND | CK+ | CK+, Vim+ | ND |
Kim et al. [28] | 2015 | 67/F | Left lateral segment | 4.5 | Low density | Heterogeneous enhancement | ND | ND | Left lobectomy | Well to moderately adenocarcinoma | Pleomorphic and spindle cells with osteoclast like giant cell | Intermingled | ND | CK19+ | Vim+ | ICC |
Boonsinsukh et al. [29] | 2018 | 45/M | Right lobe | 7.0 | Low density | Mild delayed enhancement | ND | ND | Right hepatectomy | Moderately adenocarcinoma | Spindle cells | Intermingled | ND | Vim+, AE1/AE3+, CAM5.2+, CK7+ , CK19+ | ND | ICC |
Our case | 2018 | 60/M | Caudate lobe | 7.5 | Low density | Heterogeneous enhancement | Low intensity | Iso- to high intensity | Left lobectomy and caudate lobectomy | Moderately to poorly adenocarcinoma | Spindle cells | Separated (intermingled at the border) | Â | CK7+, CK19+, EMA+ | S-100+, aSMA+, CD 10+ | ICC |