A CASE WITH SARCOMATOID HEPATOCELLULAR-CARCINOMA

Hepatocellular carcinoma (HCC) with sarcomatous features is a rare neo plasm which has been found in only 1.8% of surgically resected HCC and has a higher incidence of metastasis than usual HCC. We recently expe rienced a case of sarcomatoid HCC removed from a 49-year-old man. A su rgically resected liver revealed a well-defined grayish-white solid fi rm mass showing extensive central necrosis and infiltrative growth mar gin. Microscopically, the entire tumor was composed of pleomorphic spi ndle cells with prominent nucleoli and frequent mitosis. It showed a s inusoidal infiltrative growth pattern at the tumor-nontumor boundary. The tumor cells reacted positively with AE3 (high molecular cytokerati n) and Vimentin and reacted negatively with AE1 (low molecular cytoker atin), cytokeratin 19 carcinoembryonic antigen, alphafetoprotein, Fact or VIII, CD31 and CD68. The spindle-shaped tumor cells were considered to originate from hepatocyte rather than from bile duct epithelium or mesenchymal elements.