Sarcomatous Hepatocellular Carcinoma

Sarcomatous hepatocellular carcinoma (HCC) is a rare subtype of hepatoma, along with worse prognosis than ordinary HCC. The risk of this subtype is still unknown, but some believed it has to be related to post anti-cancer therapy.We reported a case of sarcomatous HCC and the patient did not receive any anti-cancer therapy before. He came to our outpatient department due to symptoms of generalized malaise and poor appetite. One 10 cm in sized tumor was detected by ultrasound. He received surgical resection of the tumor but the tumor recurred after 3 months, with multiple metastases to peritoneum and brain. However, even under aggressive treatment, patient still expired in 6 months after operation.We reviewed several reports of this subtype of HCC. It was known that sarcomatous HCC is hard to be distinguished with ordinary HCC before surgery. There is no evidence that adjuvant therapy including chemotherapy, radiotherapy and target therapy may improve the survival rate. It would usually be diagnosed as atypical HCC and treated as ordinary HCC, however, the prognosis is much worse; this sarcomatosis type HCC should be seriously considered.