Clinicopathological characteristics and outcome of primary sarcomatoid carcinoma and carcinosarcoma of the liver.

Background: Primary sarcomatoid carcinoma (SC) and carcinosarcoma (CS) of the liver are rare tumors.

Patients And Methods: From November 1999 to June 2011, clinicopathological features and outcome of 10 SC and 14 CS patients were retrospectively studied.

Results: In the SC group, six patients had hepatocellular carcinoma and four had cholangiocellular carcinoma, while in the CS group, it was nine and five patients, respectively. All cases of the sarcomatous components were vimentin-positive. Pan-cytokeratin were stained in sarcomatous components of the SC group, but not in the CS group. The sarcomatous component in the SC group was negative for desmin, myoglobin, HHF35, SMA, CD68, Mac387, AAT, CD34, and S100. In the CS group, the sarcomatous components in six cases were malignant fibrous histiocytomas, six were fibrosarcomas, and two were rhabdomyosarcomas. Median survival times were 9.6 and 4.8 months for the SC and CS groups, respectively (P = 0.483). In univariate analysis, favorable predictors of overall survival were asymptomatic, Child-Pugh class A, no distant metastasis, and radical resection.

Conclusions: SC and CS were highly aggressive malignancies with similar poor survival regardless of the histological and immunohistochemical findings. Early detection through regular physical examination and treatment with radical resection may improve the outcome of those patients.