Resected case of co-existing combined hepatocellular-cholangiocarcinoma and cholangiolocellular carcinoma in the same segment of normal liver

Here, we report a resected case of co-existing combined hepatocellular-cholangiocarcinoma (cHC-CC) and cholangiolocellular carcinoma (CoCC) in the same segment of the liver. A 75-year-old woman was referred and admitted to our hospital for further examination of two liver tumors. Contrast-enhanced ultrasonography, dynamic computed tomography, Gd-EOB-DTPA-enhanced magnetic resonance imaging, and abdominal angiography revealed the two tumors (diameter: tumor A, 20 mm and tumor B, 11 mm). A dynamic study of the tumors showed that in the early phase, tumor A showed peritumoral enhancement and tumor B showed hypervascu-larity. However, in the portal and equilibrated phases, both tumors were homogeneously enhanced. Tumor A was radiologically diagnosed as an intrahepatic CC and tumor B as CoCC. Subsequently, S4 and S5a segmentec-tomy was performed, and tumors A and B were pathologically diagnosed as cHC-CC and CoCC, respectively. No recurrence was observed in the patient after postoperative 2 years 6 months. To the best of our knowledge, cases in which cHC-CC and CoCC co-exist in the same segment are extremely rare, which makes the present case valuable.