Parveen Kumar1* and Nalini Bansal2
1Department of Radiodiagnosis and Imaging, Fortis Escort Heart Institute, India 2Department of Histopathology, Fortis Hospital, IndiaFulltext PDF
Sarcomatoid hepatocellular carcinoma is a rare malignancy with very poor prognosis. The study reports the case of a 54-year-old male who presented with post Trans Arterial Chemoembolization (TACE) residual/recurrent Hepatocellular Carcinoma (HCC). He had a history of hepatitis C for 10 years. Dynamic MRI showed two distinct lesions, one located in caudate lobe and another in segment VII. The lesion in caudate lobe showed delayed and prolonged peripheral enhancement with non-enhancing central component. The segment VII lesion showed faint arterial phase enhancement which persisted in portal venous phase without any washout. Patient was scheduled for liver transplantation. On histopathology the larger lesion showed spindle cells arranged in sheets having pleomorphic vesicular nuclei. Immunohistochemistry was positive for vimentin, AFP, Ck 8/18, Pan Ck, desmin and myogenin and thus a diagnosis of sarcomatoid hepatocellular carcinoma was established. Microscopy of segment VII lesion was consistent with high grade dysplastic nodule. This case describes the imaging features of sarcomatoid HCC and highlights the importance of histopathology and immunohistochemistry in final diagnosis.
Kumar P, Bansal N. Sarcomatoid Hepatocellular Carcinoma: A Case Report and Imaging Findings. Ann Clin Case Rep. 2021; 6: 1921..