{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T05:07:02Z","timestamp":1775797622573,"version":"3.50.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hepatic carcinosarcoma (HCS) is an extremely rare primary malignant liver tumor characterized by aggressive biological behavior, early invasion, and poor prognosis. Owing to its non-specific clinical manifestations and imaging features, preoperative diagnosis remains challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report<\/jats:title>\n                    <jats:p>We report a 54-year-old man who presented with persistent fever and unexplained weight loss for 2 weeks. Imaging studies revealed a large space-occupying lesion in the right hepatic lobe, with a preliminary suspicion of cholangiocarcinoma. Liver biopsy findings suggested a sarcomatous lesion. Further computed tomography (CT) evaluation revealed a heterogeneous hypodense mass (11 cm) in the right liver, encircling the right portal vein branch and accompanied by mild bile duct dilatation. Laboratory tests showed normal levels of tumor markers including alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and carbohydrate antigen 125 (CA125). The patient subsequently underwent laparoscopic right hepatectomy and cholecystectomy. Postoperative pathology revealed extensive tumor necrosis with residual components consisting of approximately 30% poorly differentiated hepatocellular carcinoma and 70% sarcomatoid tissue, confirming the diagnosis of hepatic carcinosarcoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hepatic carcinosarcoma often presents with insidious and non-specific clinical and radiological features, resulting in frequent misdiagnosis. Complete resection remains the primary treatment modality. This case underscores the importance of integrating imaging, histopathology, and immunohistochemical analysis for confirming this rare tumor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1805372","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T04:25:49Z","timestamp":1775795149000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hepatic carcinosarcoma with predominant sarcomatous component mimicking intrahepatic cholangiocarcinoma: a case report and literature review"],"prefix":"10.3389","volume":"13","author":[{"given":"Xuda","family":"Ji","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University","place":["Jinan, Shandong, China"]},{"name":"Shandong Provincial Hospital, Shandong University","place":["Jinan, Shandong, China"]},{"name":"Shandong First Medical University (Shandong Academy of Medical Sciences)","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meijia","family":"Fu","sequence":"additional","affiliation":[{"name":"Shandong First Medical University (Shandong Academy of Medical Sciences)","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fangfeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University","place":["Jinan, Shandong, China"]},{"name":"Shandong Provincial Hospital, Shandong University","place":["Jinan, Shandong, China"]},{"name":"Shandong First Medical University (Shandong Academy of Medical Sciences)","place":["Jinan, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1016\/j.prp.2015.09.007","article-title":"Hepatic carcinosarcoma: evidence of polyclonal origin based on microsatellite","volume":"211","author":"Gu","year":"2015","journal-title":"Pathol Res Pract"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2225","DOI":"10.21873\/anticanres.14184","article-title":"Primary hepatic carcinosarcoma composed of hepatocellular carcinoma, cholangiocarcinoma, osteosarcoma and rhabdomyosarcoma with poor prognosis","volume":"40","author":"Liu","year":"2020","journal-title":"Anticancer Res."},{"key":"B3","doi-asserted-by":"publisher","first-page":"3000605211050539","DOI":"10.1177\/03000605211050539","article-title":"Rare primary hepatic carcinosarcoma composed of hepatocellular carcinoma, cholangiocarcinoma, and sarcoma: a case report","volume":"49","author":"Liang","year":"2021","journal-title":"J Int Med Res."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1470419","DOI":"10.3389\/fmed.2024.1470419","article-title":"Primary hepatic carcinosarcoma: a case report with insights from retrospective analysis of clinical characteristics and prognostic factors","volume":"11","author":"Zhao","year":"2024","journal-title":"Front Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e37013","DOI":"10.1097\/MD.0000000000037013","article-title":"Hepatocellular carcinoma combined with sarcomatoid hepatocellular carcinoma: a case report","volume":"103","author":"Li","year":"2024","journal-title":"Medicine."},{"key":"B6","doi-asserted-by":"publisher","first-page":"102520","DOI":"10.1016\/j.clinre.2024.102520","article-title":"Primary hepatocellular carcinosarcoma: a case series and literature review","volume":"49","author":"Qiao","year":"2025","journal-title":"Clin Res Hepatol Gastroenterol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"8621","DOI":"10.1097\/JS9.0000000000002948","article-title":"Prognostic impact of adjuvant therapy following surgical resection in primary hepatic sarcomatoid carcinoma: a retrospective cohort study","volume":"111","author":"Ji","year":"2025","journal-title":"Int J Surg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"336","DOI":"10.4321\/S1130-01082011000600014","article-title":"Primary carcinosarcoma of the liver: an unusual case with clearly separated epithelial and mesenchymal components","volume":"103","author":"Aparicio","year":"2011","journal-title":"Rev Esp Enferm Dig."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-3307394\/v1","article-title":"Spontaneous rupture as the initial symptom of primary hepatic carcinosarcoma: a case report","author":"Zhao","year":"2024","journal-title":"Asian J Surg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1630","DOI":"10.3748\/wjg.v20.i6.1630","article-title":"Characterization of primary hepatic carcinosarcoma by contrast-enhanced ultrasonography: a case report","volume":"20","author":"Liu","year":"2014","journal-title":"World J Gastroenterol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s40644-018-0141-0","article-title":"Primary carcinosarcoma of the liver: imaging features and clinical findings in six cases and a review of the literature","volume":"18","author":"Li","year":"2018","journal-title":"Cancer Imaging."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1715","DOI":"10.1007\/s11605-012-1946-y","article-title":"Clinicopathological characteristics and outcome of primary sarcomatoid carcinoma and carcinosarcoma of the liver","volume":"16","author":"Wang","year":"2012","journal-title":"J Gastrointest Surg."},{"key":"B13","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/S1499-3872(11)60015-5","article-title":"Primary hepatic carcinosarcoma","volume":"10","author":"Celikbilek","year":"2011","journal-title":"Hepatobiliary Pancreat Dis Int."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.1007\/s00595-013-0612-7","article-title":"Carcinosarcoma of the liver: report of a case","volume":"44","author":"Yamamoto","year":"2014","journal-title":"Surg Today."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.4254\/wjh.v9.i26.1081","article-title":"Diffusion weighted magnetic resonance imaging of liver: principles, clinical applications and recent updates","volume":"9","author":"Shenoy-Bhangle","year":"2017","journal-title":"World J Hepatol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"487","DOI":"10.11152\/mu-2002","article-title":"Imaging features of ultrasound and contrast-enhanced ultrasound in primary hepatic carcinosarcoma: three cases report","volume":"21","author":"Liu","year":"2019","journal-title":"Med Ultrason."},{"key":"B17","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1097\/00000478-199603000-00003","article-title":"Monoclonal origins of malignant mixed tumors (carcinosarcomas). Evidence for a divergent histogenesis","volume":"20","author":"Thompson","year":"1996","journal-title":"Am J Surg Pathol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"100042","DOI":"10.1016\/j.modpat.2022.100042","article-title":"Hepatic sarcomatoid carcinoma is an aggressive hepatic neoplasm sharing common molecular features with its conventional carcinomatous counterparts","volume":"36","author":"Yoshuantari","year":"2023","journal-title":"Mod Pathol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"426","DOI":"10.3350\/cmh.2024.0686","article-title":"Integrated molecular characterization of sarcomatoid hepatocellular carcinoma","volume":"31","author":"Sun","year":"2025","journal-title":"Clin Mol Hepatol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"423","DOI":"10.18999\/nagjms.80.3.423","article-title":"Primary hepatic carcinosarcoma with multimodal treatment","volume":"80","author":"Kurita","year":"2018","journal-title":"Nagoya J Med Sci."},{"key":"B21","doi-asserted-by":"publisher","first-page":"3985","DOI":"10.1016\/j.asjsur.2024.04.193","article-title":"Hepatic carcinosarcoma demonstrating exophytic and rapid growth on imaging","volume":"47","author":"Xie","year":"2024","journal-title":"Asian J Surg."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1805372\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T04:25:50Z","timestamp":1775795150000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1805372\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,10]]},"references-count":21,"alternative-id":["10.3389\/fmed.2026.1805372"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1805372","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,10]]},"article-number":"1805372"}}