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Primary adenosquamous carcinoma of the liver

Primary hepatic adenosquamous carcinoma (ASC) is a rare pathologic type of liver cancer. It is identified as a liver tumor containing both adenocarcinoma and squamous cell carcinoma originated from the same stem cell. ASC is considered to have a higher grade malignancy than primary hepatocellular carcinoma (HCC). Now, we reported such a case. A previously healthy 74-year-old woman presented with health checkup. The results of laboratory examinations were shown as below: carcinoembryonic antigen (CEA), 16.75 ng/mL, saccharide antigen 199 (CA199), 876.40 U/mL. Abdominal contrast-enhanced computed tomography showed a mass located in the left liver, and a space-occupying lesion was found in the left hepatic duct along with dilated distal bile ducts. The parenchyma of the lesion was obviously enriched after being potentiated. The hilar structure was clear and there was no evidence of lymph node metastasis or distant metastasis (Figure 1A). The patient then underwent left hemihepatic resection, cauda lobectomy, and intraperitoneal dissection. Histologic examination and immunohistochemical staining confirmed the diagnosis of left hepatic adenosquamous carcinoma (Figure 1B-D). Postoperative examination revealed the expression of CA199 was significantly reduced (73.00 U/mL), the results of CEA and biochemical examination were normal. After the operation, the patient did not receive subsequent therapy and died of tumor recurrence about 21 months later.