Adenosquamous carcinoma of the liver: Clinicopathologic features in 12 patients and review of the literature

We present and compare the clinical features and outcomes of 12 patients with primary adenosquamous carcinoma (ADS-CCC) of the liver who underwent hepatic resection at our institution with those of 29 cases whose surgical treatment were reported in the literature. Peripheral cholangiocarcinoma (CCC) occurs less frequently than hepatocellular carcinoma in most parts of the world. Reports of surgically treated cases of ADS-CCC are seen only sporadically because of the low resectability rate, difficulty in making an early diagnosis, and the poor prognosis. Furthermore, a clinicopathological study based on a certain number of surgically treated cases is still lacking. From 1977 to 2001, 12 cases of hepatic ADS-CCC who underwent hepatic resection were reviewed in respect to clinical features and long-term results. The clinical features and outcomes of the 29 patients who underwent hepatic resection reported in the literature are also summarized for comparison. Of 228 surgically treated CCC patients in our institute, 12 (5.3%) were ADS-CCC. A male predominance was observed in our study and in the reported cases. In our series, prominent body weight loss and prominent relationship to hepatolithiasis were observed. The prognosis is dismal in patients with ADS-CCC who undergo hepatic resection; however, there was no significant difference in overall survival between the ADS-CCC and CCC groups. In our series, the 1-, 2-, and 3-year survival rates of ADS-CCC and CCC patients were 18.8%, 0%, and 0% and 32.8%, 14.8%, and 9.5%, respectively. ADS-CCC is prominently related to body weight loss and hepatolithiasis in our series compared with the reported cases. The prognosis of patients with ADS-CCC who undergo hepatic resection is dismal because of the specific biological behavior of ADS-CCC.