Primary undifferentiated carcinoma with osteoclast-like giant cells in liver and rapidly developing multiple metastases
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CASE REPORT
Primary undifferentiated carcinoma with osteoclast‑like giant cells in liver and rapidly developing multiple metastases after curative hepatectomy: a case report Naoki Kamitani1 · Takeo Nomi1 · Daisuke Hokuto1 · Takahiro Yoshikawa1 · Yasuko Matsuo1 · Masayuki Sho1 Received: 1 May 2020 / Accepted: 19 July 2020 / Published online: 18 August 2020 © The Japan Society of Clinical Oncology 2020
Abstract A 64-year-old man was diagnosed with cholangiocellular carcinoma based on preoperative computed tomography and magnetic resonance imaging and underwent laparoscopic segmentectomy (Segment 8) of the liver for radical operation. Pathological examination revealed the presence of an undifferentiated carcinoma with osteoclast-like giant cells, which were categorized as T3N0M0 and Stage III based on the third English edition of the Japanese classification of liver cancer. The patient was treated with three courses of combination chemotherapy, which included gemcitabine (1000 mg/m2) and cisplatin (25 mg/m2), as well as S-1 (120 mg/day) for adjuvant chemotherapy. At two months after the operation, CT revealed multiple liver- and lung metastases. Thereafter, the patient was prescribed the molecularly targeted drug, lenvatinib (12 mg/day). However, lenvatinib was not effective, as evident by the extension of several metastases. Testing for microsatellite instability was negative. The patient died 5 months after the operation. We experienced a case of primary undifferentiated carcinoma with osteoclast-like giant cells in the liver showed rapidly developing multiple metastases after curative liver resection. Keywords Undifferentiated carcinoma · Liver · Osteoclast-like giant cell
Introduction Surgery is the mainstay of treatment for primary carcinoma in the liver. Optimal treatment strategies for hepatocellular carcinoma (HCC) and cholangiocellular carcinoma (CCC) are being established because HCC and CCC are the most abundant among the primary liver tumors. However, * Takeo Nomi nomi@naramed‑u.ac.jp Naoki Kamitani nkamitani@naramed‑u.ac.jp Daisuke Hokuto hokuto@naramed‑u.ac.jp Takahiro Yoshikawa [email protected] Yasuko Matsuo yasuko‑tsuji@naramed‑u.ac.jp Masayuki Sho m‑sho@naramed‑u.ac.jp 1
Department of Surgery, Nara Medical University, 840 Shijo‑Cho, Kashihara, Nara 634‑8522, Japan
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cases of primary undifferentiated carcinoma in the liver are extremely rare [1]. This type of carcinoma is generally reported to show aggressive features and a poor prognosis [2, 3]. However, due to its rarity, the standard treatment strategies have thus far not been established. Herein, we report a case of primary undifferentiated carcinoma in liver with osteoclast-like giant cells (OGC) which featured rapidly developing multiple metastases after curative hepatectomy.
Case report A 64-year-old man was admitted to our hospital for examination and treatment of a liver tumor. He had a medical history of chronic hepatitis due to hepatitis B virus (HBV) and alcohol use. A physical examination showed nei
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