Abstract:
Hepatobiliary mucoepidermoid carcinoma is a rare malignant tumor comprising mucous, intermediate, and epidermoid cells. Herein, we presented a case of primary liver mucoepidermoid carcinoma preoperatively misdiagnosed as conventional intrahepatic cholangiocarcinoma. A 67-year-old male was admitted to our hospital. Preoperative laboratory tests showed increased aspartate transaminase, alanine transaminase, and carbohydrate antigen 19-9. Abdominal Computer Tomography revealed a 4.8 × 4.9 cm liver mass in segment VI. A preliminary diagnosis of intrahepatic cholangiocarcinoma was made, with undergoing partial hepatectomy. However, on histopathology, the tumor comprised a mixture of epidermoid, mucous, and intermediate cells with diffuse infiltrating at the tumor margin. On special stains, mucous and intermedia cells were positive for mucicarmine and Alcian blue, whereas epidermoid cells were positive for Keratin 5/6 and p63. Intermediate cells are also positive for p63. All tumor cells were positive for Keratin 7. The Ki-67 index was 35%. The final diagnosis was primary hepatic mucoepidermoid carcinoma. Although rare, hepatic mucoepidermoid carcinoma should be considered in the intrahepatic cholangiocarcinoma differential diagnosis. We reviewed previous studies and found that hepatobiliary mucoepidermoid carcinoma is more likely to originate from the biliary tract adjacent to the tumor.
摘要:
肝胆粘液表皮样癌是一种罕见的恶性肿瘤,包括粘液,中间,和表皮样细胞。在这里,我们介绍了1例原发性肝黏液表皮样癌术前误诊为常规肝内胆管癌。一名67岁男性入院。术前实验室检查显示天冬氨酸转氨酶升高,丙氨酸转氨酶,和糖类抗原19-9.腹部计算机断层扫描显示VI段有4.8×4.9cm的肝脏肿块。初步诊断为肝内胆管癌,接受部分肝切除术。然而,在组织病理学上,肿瘤由表皮样混合物组成,粘液,和中间细胞在肿瘤边缘弥漫性浸润。在特殊污渍上,粘液细胞和中间细胞对粘液碱和阿尔辛蓝呈阳性,而表皮样细胞对角蛋白5/6和p63呈阳性。中间细胞对p63也是阳性的。所有肿瘤细胞对角蛋白7呈阳性。Ki-67指数为35%。最终诊断为原发性肝粘液表皮样癌。虽然罕见,肝黏液表皮样癌在肝内胆管癌的鉴别诊断中应考虑。我们回顾了以前的研究,发现肝胆粘液表皮样癌更可能起源于肿瘤附近的胆道。