Sarcomatoid Cholangiocarcinoma with Osteoclast-Like Giant Cells Developing within a Normal Liver: Report of a Case and Review of Literature

Evangelina Florou, Reena Ravikumar, Rosa Miquel and Andreas Prachalias

Department of HPB Surgery, Kings College Hospital, UK
Department of Pathology, Institute of Liver Studies, Kings College Hospital, UK

^*Correspondance to: Reena Ravikumar 

 PDF  Full Text DOI: 10.25107/2474-1647.2583

Abstract

Background: Sarcomatoid transformation of primary liver tumors is rare, more so that of sarcomatoid or spindle cell Intrahepatic Cholangiocarcinoma (ICCA) with an Osteoclast-like (OCL) giant cell component. We describe a new case developed in the context of normal background liver. Case Report: A 53year-old Caucasian male, with no previous liver pathology, presented with nonspecific symptoms including vague abdominal pain, general malaise and abnormal Liver Function Tests (LFTs) with mixed cholestatic and hepatitis profile. Cross-sectional imaging demonstrated a large right side liver tumour and completion of staging did not reveal distant metastases. The tumour was technically resectable and the patient underwent a right hepatectomy with curative intent. Histology showed a cholangiocarcinoma with extensive sarcomatous changes and osteoclastlike type giant cells. Two months post-surgery, the patient developed hepatic recurrence and disseminated disease. Conclusion: Sarcomatoid Cholangiocarcinoma (S-ICCA) has an extremely poor prognosis. Whilst tumor may be resectable at the time of presentation, the disease recurs or metastasizes soon afterwards, fact that suggests that alternate management strategies should be employed to improve prognosis.

Keywords

Cholangiosarcoma; Osteoclast-like giant cells; Sarcomatous transformation of sarcomatoid/spindle cell cholangiocarcinoma; Intrahepatic cholangiocarcinoma

Cite the article

Florou E, Ravikumar R, Miquel R, Prachalias A. Sarcomatoid Cholangiocarcinoma with Osteoclast- Like Giant Cells Developing within a Normal Liver: Report of a Case and Review of Literature. Clin Surg. 2019; 4: 2583..