Combined Hepatocellular and Cholangiocarcinoma: CT Findings with Emphasis on Multiphasic Helical CT
Sith Phongkitkarun MD*, Tanop Srisuwan MD*, Pattana Sornmayura MD**, Janjira Jatchavala MD*
Affiliation : * Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University ** Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Objective : To describe CT findings of patients with combined hepatocellular carcinoma and cholangio-
carcinoma (HCC-CC) in correlation with clinical data and histopathological results.
Materials and Methods : Ten from 31 cases whose CT study was available were reviewed retrospectively in the
aspect of imaging findings, clinical data, and pathological results.
Results : Most of the tumors were hypodense solitary mass with gradually enhanced after contrast administra-
tion. Bile duct dilatation was observed in two cases. The overall CT findings were more similar to CC rather
than HCC despite the pathological result showing predominant HCC component. Serum alpha-fetoprotein
level was normal or mildly elevated while an elevated concentration of carbohydrate antigen 19-9 was
observed. Hepatitis profiles showed positive to hepatitis B virus infection in four cases and hepatitis C virus
infection in one case.
Conclusion : The diagnosis of combined HCC-CC should be considered if the tumor has similar findings to CC
without bile duct dilatation on cirrhotic liver and the patient has normal or low rising of the AFP level with
or without elevated CA 19-9 level. In non-cirrhotic liver, the finding is non-specific.
Keywords : Tomography, Spiral Computed Carcinoma, Hepatocellular cholangiocarcinoma
