화농성 간농양으로 오인한 혼합형 간세포-담관암종 1예

• Published in: Journal of liver cancer Vol. 17; no. 2; pp. 174 - 181
• Main Authors: 백승석, Seung Suk Baek, 윤아일린, Eileen L. Yoon, 김현정, Hyun-jung Kim, 배경은, Kyung Eun Bae, 박경미, Kyeongmee Park, 최원충, Won-choong Choi
• Format: Journal Article
• Language: Korean
• Published: 대한간암학회 15.09.2017
• Subjects: Combined hepatocellular-cholangiocarcinoma; Hepatocellular carcinoma; Liver abscess; 의학일반
• ISSN: 2288-8128; 2383-5001
• DOI: 10.17998/jlc.17.2.174

Heterogeneous features of liver cancer can mimic liver abscess. Therefore it is essential to double- check tumor markers in the diagnosis of liver abscess. Herein, we report a case of combined hepatocellular-cholangiocarcinoma (cHC) occurred in an unrecognized chronic hepatitis B patient initially misdiagnosed as liver abscess. A 49-year old male initially presented with chill, right upper quadrant pain, and a liver mass. Mass showed peripheral enhancement in arterial phase of computed tomography, which was not typical for hepatocellular carcinoma (HCC). Strikingly elevated alpha-fetoprotein and fine needle aspirated pathology revealed HCC. Despite discordant image findings he was treated with transarterial chemoembolization. He was treated with sorafenib due to metastatic retrocaval lymphadenopathy afterwards. The mass presumed to be HCC progressed with sorafenib. It was surgically resected and he was finally confirmed as cHC. Discordant tumor markers with presumptive image findings should prompt the suspicion of rare type of primary liver cancer, the cHC. (J Liver Cancer 2017;17:174-181)