부산대학교 도서관

A 61-year-old man was referred to our hospital for a hepatic mass in segment 6 detected by abdominal ultrasonography. All serologic markers for HBV and HCV infections were negative. The serum concentration of protein induced by vitamin K absence or antagonist Ⅱ was elevated to 86 mAU/ml. Enhanced computed tomography revealed enhancement of the tumor in the early phase and washout during the late phase. Gadolinium-ethoxybenzyl-diethylene-triaminepentaacetic acid-enhanced MRI showed no tumors except for the tumor detected in the hepatobiliary phase; this tumor was diagnosed as hepatocellular carcinoma (HCC), and hepatic resection was planned. At laparotomy, intraoperative ultrasonography indicated a 3-mm nodular lesion close to the tumor in segment 6. Therefore, we performed partial hepatic resection including this small nodule during the operation. On histopathological examination, the tumor in segment 6 was diagnosed as a moderately differentiated HCC, and the small nodule was found to be composed of proliferating small irregular tubules. Immunohistochemical examination showed positive immunoreactivity of the carcinoma cells for cytokeratin (CK)-7, CK-19, NCAM and c-kit, and especially of the luminal surfaces of the tubules for EMA, findings which are typical of cholangiolocellular carcinoma (CoCC). We report a case of CoCC with a concurrent HCC.