Abstract
Two cases of well-differentiated hepatocellular carcinoma (HCC) with focal biliary differentiation are presented. The distinct histological features of these neoplasms and the unusually protracted clinical course of 8 and 10 years distinguish them from previously described pathological categories of primary hepatic tumors. Electron microscopic and immunohistochemical findings support a dual hepatic and bile duct differentiation of the tumor cells. If additional examples of this tumor are found to be associated with a similarly prolonged symptom-free survival, the distinction of this entity from traditional, rapidly fatal HCC becomes important. Less aggressive therapeutic options may be entertained.
MeSH terms
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Adult
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Bile Ducts / pathology
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Carcinoembryonic Antigen / metabolism
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Carcinoma, Hepatocellular / metabolism
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Carcinoma, Hepatocellular / pathology*
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Carcinoma, Hepatocellular / ultrastructure
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Cell Transformation, Neoplastic / pathology*
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Chorionic Gonadotropin / metabolism
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Chromogranins / metabolism
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Female
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Hepatic Duct, Common / pathology
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Humans
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Immunohistochemistry
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Keratins / metabolism
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Liver Neoplasms / metabolism
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Liver Neoplasms / pathology*
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Liver Neoplasms / ultrastructure
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Male
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Membrane Glycoproteins / metabolism
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Microscopy, Electron
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Middle Aged
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Mucin-1
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Phosphopyruvate Hydratase / metabolism
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Prognosis
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Time Factors
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Vimentin / metabolism
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alpha 1-Antichymotrypsin / metabolism
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alpha 1-Antitrypsin / metabolism
Substances
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Carcinoembryonic Antigen
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Chorionic Gonadotropin
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Chromogranins
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Membrane Glycoproteins
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Mucin-1
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Vimentin
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alpha 1-Antichymotrypsin
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alpha 1-Antitrypsin
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Keratins
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Phosphopyruvate Hydratase