Hepatic carcinosarcoma with rhabdomyosarcoma: A case report and review of literature

Objective To analyze the clinical and pathological manifestations of a hepatic carcinosarcoma case with rhabdomyosarcoma components (HCSR). Methods A case of HCSR was observed by macroscopy, microscopy, immunohistochemistry and electron microscopy, along with thorough review of correlated literatures. Results The tumor tends to occur in elder patients without differences on gender. Epigarstric sicknesses, AFP rising in serum, and a mass on the right liver shown in radiography are commonly initial signs. It was composed of both hepatic carcinoma and variously differentiated sarcoma components, with identifiable rhabdomyosarcoma. Immunohistochemistry showed that the hepatic carcinosarcoma was positive of epithelial markers and mesenchymatous component was diffuse positive of Vimentin, and mosaic positive of SDHB, CD117, while rhabdomyosarcoma was positive of muscular markers. Transmission electron microscopy showed the tumor had both epithelial and rhabdomyosarcoma ultra-microstructure. Conclusion HCSR is a very rare type and highly malignant tumor with a dismal prognosis, hardly demonstrating unique clinical manifestations. Diagnosis and differential diagnosis rely on combination of histomorphology, immunohistochemistry and ultra-microstructure observation.