Summary
Among 579 autopsy cases of hepatocellular carcinoma (HCC), 55 cases (9.4%) exhibited a sarcomatous appearance. The incidence of HCC with a sarcomatous appearance has been increasing over the past 17 years. A sarcomatous appearance was found in 20 out of 335 autopsy cases of HCC (5.9%) during the 12 years from 1969 to 1980, and in 35 out of 244 autopsy cases of HCC (14.3%) during the last 6 years, when effective anticancer therapies, such as the one-shot injection of anticancer agents into the hepatic artery (one-shot therapy) and transcatheter arterial embolization (TAE), have become popular. A sarcomatous appearance was found in 20.9% of the cases undergoing anticancer therapy and in 4.2% of the cases not undergoing anticancer therapy. Among the various anticancer therapies, the sarcomatous appearance was most frequent (27.6%) in cases with repeated TAE. Thus, a close relationship between the sarcomatous appearance in HCC and anticancer therapies was suggested. Regarding the development of the sarcomatous appearance, we presume that it may be caused by the pyenotypic change of HCC cells caused by anticancer therapy, or that a number of factors, including anticancer therapy, may accelerate the proliferation of the sarcomatous cells existing in the original tumor as one of the histological components. In order to clarify the true nature of sarcomatous lesions in HCC, further histological and biological studies are required.
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References
Azzopardi G, Chepick OF, Hartmann WH, et al. (1981) Histological ty** of breast tumors. World Health Organization, Geneva
Battifora H (1976) Spindle cell carcinoma: ultrastructural evidence of squamous origin and collagen production by the tumor cells. Cancer 37: 2275–2282
Chang WL, Agha FP, Morgan WS (1983) Primary sarcoma of the liver in adults. Cancer 51: 1510–1517
Edmondson EA, Steiner PE (1954) Primary carcinoma of the liver: A study of 100 cases among 48 900 necropsies. Cancer 7: 462–503
Isomura T, Arakawa M, Wada T, et al. (1979) Hepatocellular carcinoma with sarcoma-like transformation: a case report. Acta Hepatol Jpn 20: 70–75
Jaffe RH (1924) Sarcoma and carcinoma of the liver following cirrhosis. Arch Intern Med 33: 330–342
Japan Liver Cancer Study Group (1979) Surgery and followup study of primary liver cancer in Japan, report 4. Acta Hepatol Jpn 20: 433–441
Kakizoe S, Kojiro M, Nakashima T (1987) Hepatocellular carcinoma with sarcomatous change. Clinicopathologic and immunohistochemical studies of 14 autopsy cases. Cancer 59: 310–316
Kawabata K (1980) Pathomorphologic studies of hepatocellular carcinoma: a study of the lymph node with marked metastasis of hepatocellular carcinoma. Acta Hepatol Jpn 21: 203–215
Kreyberg L (1981) Histological ty** of lung tumors. World Health Organization, Geneva
Kuwano H, Sonoda T, Hashimoto T, et al. (1984) Hepatocellular carcinoma with oeteolast-like giant cells. Cancer 54: 837–842
Nagamine Y, Sasaki K, Kaku K, et al. (1978) Hepatic sarcoma associated with hepatoma. Acta Pathol Jpn 31: 815–824
Nakashima T, Kojiro M (1987) Hepatocellular Carcinoma —an atlas of its pathology. Springer-Verlag International, Tokyo
Nakashima T, Kojiro M, Kawano Y, et al. (1982) Histologic growth pattern of hepatocellular carcinoma: relationship to orcein (hepatitis B surface antigen)-positive cells in cancer tissue. Hum Pathol 16: 536–568
Oota K (1977) Histological ty** of gastric and oesophageal tumors. World Health Organization, Geneva
Shibasaki K, Kojima N, Fujita K, et al. (1975) Long-term survived cases of hepatocellular carcinoma and their clinicopathological study: three cases of protracted clinical course. Acta Hepatol Jpn 16: 431–440
Tsujimoto M, Aozasa K, Nakajima Y, et al. (1984) Hepatocellular carcinoma with sarcomatous proliferation showing an unusual and wide-spread metastasis. Acta Pathol Jpn 34: 839–845
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Kojiro, M., Sugihara, S., Kakizoe, S. et al. Hepatocellular carcinoma with sarcomatous change: a special reference to the relationship with anticancer therapy. Cancer Chemother. Pharmacol. 23 (Suppl 1), S4–S8 (1989). https://doi.org/10.1007/BF00647229
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DOI: https://doi.org/10.1007/BF00647229