[A Resected Case of Synchronous Double Cancer of Combined Hepatocellular-Cholangiocarcinoma and Hepatocellular Carcinoma].

A 78-year-old woman diagnosed with hepatitis B had been treated with entecavir at our hospital. In December 202X, blood test showed elevated AFP 19 ng/mL and PIVKA-Ⅱ 46 mAU/mL. Abdominal CT showed tumors in S2 and S6/7 of the liver, and the patient was referred to our department. Abdominal CT showed that the S6/7 tumor was 40 mm in size, with contrast enhancement in the early phase and little contrast enhancement in the late phase, while the S2 tumor was 15 mm in size with both early and late phase contrast enhancement. MRI diffusion-weighted images showed hyperintensity in both S2 and S6/7 tumors. The patient was diagnosed with hepatocellular carcinoma and a posterior segment resection of the liver and a partial S2 resection of the liver were performed. The resected specimen showed a 10 mm whitish nodule in S2 and a 40 mm yellowish nodule in S6/7. Immunohistological findings of the resected specimen showed that the S2 tumor was positive for AFP, Glypican-3, CK19, and MUC-1, and the pathological diagnosis was co-existing combined hepatocellular cholangiocarcinoma and hepatocellular carcinoma. The patient was discharged on post-operative day 11 and has been alive without recurrence after surgery.