PMC7424173_01
The cHCC-CCA nodule in Case 1. The computed tomography (CT) scan shows a tumor in segment 2, which is enhanced in the portal phase (a) and washed out in the late phase (b). This tumor macroscopically appeared solid white (c). Pathological findings indicating that the nodule consists of two components (d): CCA (e) and HCC (f).
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Computed tomography (CT) showed two tumors (maximum size 21 mm) (Fig. 1a and b). Postoperative pathological examination revealed three tumors (Fig. 1c): one of which was diagnosed as cHCC-CCA (Fig. 1d-f).
PMC7424173_02
The cHCC-CCA nodule of Case 2. The computed tomography (CT) scan shows a small enhanced nodule (white arrow) in the portal phase (a). The nodule is not visible in the late phase (b). cHCC-CCA (white square) (c). Microscopically, the tumor consists of two components: CCA (e) and HCC (f).
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Preoperative examination revealed three liver tumors (Fig. 2a and b) that were 20 mm or less in diameter, thereby meeting Milan criteria. Pathological examination showed two viable liver tumors (Fig. 2c): one cHCC-CCA (Fig. 2d-f) and one
PMC7424173_03
The cHCC-CCA nodule of Case 3. The computed tomography (CT) scan indicates three tumors in portal (a) and late (b) phases. The tumor:indicated by the white arrow:is the cHCC-CCA nodule; the other tumors (arrowheads) are HCC nodules (c). Pathological findings indicate that the nodule consists of two components (d): CCA (e) and HCC (f).
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PMC7424173_03_gr3.jpg
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Preoperative CT examination suggested five tumors with a maximum diameter of 29 mm, thus not meeting Milan criteria (Fig. 3a and b). One tumor was cHCC-CCA (21 mm in diameter); the other two were HCC (Fig. 3c-f).
PMC7424173_04
The cHCC-CCA nodule of Case 4. The computed tomography (CT) scan indicates three tumors in the portal (a) and late (b) phases. The arrow indicates the cHCC-CCA nodule while the arrowheads show HCC nodules. Macroscopically, the cHCC-CCA nodule:indicated by the arrow:is white (c), while the multiple HCC nodules are green (d). The microscopic findings show that the nodule consists of two components (e): CCA (f) and HCC (g), surrounded by a CCA component.
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HCC tumors (Fig. 4a and b). His C-P score was grade C (10 points) and his MELD score was 20 points. The largest tumor was diagnosed as cHCC-CCA (36 mm in diameter) (Fig. 4c and e-g); the other tumors were HCCs (Fig. 4d).