As rare condition,
mucoepidermoid carcinoma may occur in liver although its etiology and pathogenesis is still unclear. We report here a case of intrahepatic
mucoepidermoid carcinoma misdiagnosed as
cholangiocarcinoma and
squamous cell carcinoma by preoperative radiologic and intraoperative histological examinations, respectively. A 60-year-old woman presented with a 1-month history of progressive
jaundice, epigastric discomfort, and
weight loss with slightly increased
carbohydrate antigen 19-9 (CA19-9). Computed tomography (CT) showed a large
tumor, 8.0 cm in diameter, in the left lobe of the liver. A preliminary diagnosis of a
cholangiocarcinoma of the liver was made. In the intraoperative histological examination, a diagnosis of
squamous cell carcinoma was made based on predominantly invasive epidermoid cells with abundant keratinization and absence of
mucin-producing cell component. However, postoperative histological diagnosis of the lesion was mucoepidermiod
carcinoma of liver by thoroughly microscopical inspection and the presence of
mucin-producing cells confirmed by
Alcian blue staining. Despite surgical excision and
chemotherapy, the
tumor showed very aggressive
malignancy with
tumor recurrence. The patient died shortly afterward, surviving 6 months after surgery. Due to its rarity and distinct morphological features,
mucoepidermoid carcinoma might be erroneously interpreted as
squamous cell carcinoma by those who were not familiar with this condition in unusual locations. Therefore, removal of sufficient tissue from different portions of the lesion is essential for the surgeons and pathologists to make a precise diagnosis in the intraoperative histological examination.
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