Collision tumour: A case report of mixed hepatocellular and cholangiocarcinoma

Abstract

Introduction: Combined hepatocellular-cholangiocarcinoma (cHCC-CC), also known as mixed HCC-CC, is a rare form of primary liver cancer, showing histopathological features of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare variant of primary hepatic cancer, with the reported incidence of this tumor varying between 0.4 and 4.7%. The purpose of this case report is to document this rare case in the literature so as to increase the awareness of this entity in our locality and beyond.
The Case: We present a case of a 40 year old black male patient who presented with a seven month history of malaise, three month history of epigastric pain, jaundice, and weight loss. He had history of significant alcohol intake and cigarette smoking. Liver function test was deranged. Serology showed positivity of hepatitis B surface and core antigens. Also hepatitis C antigen and antibody were positive. Ultrasound revealed an enlarged liver with at least two well defined irregular hypo echoic  masses. Histology reported a mixed hepatocellular and cholangiocarcinoma. He was managed conservatively and died after about a month on admission in hospital.
Conclusion: Mixed hepatocellular and cholangiocarcinoma is a rare tumour with bad prognosis. A multidisciplinary approach and prompt treatment is required in the management of patients with this malignancy.

Key words: Hepatocellular carcinoma, Cholangiocarcinoma, Collision, Mixed tumour.