Synchronous double cancers of primary hepatocellular carcinoma and intrahepatic cholangiocarcinoma: a case report and review of the literature

We report a case of double primary liver cancer comprising hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). A 58-year-old Chinese man without obvious liver cirrhosis was diagnosed with multiple HCC in segment V (SV) and segment VIII (SVIII) of the liver. Preoperative abdominal magnetic resonance imaging revealed two solid masses in SV and SVIII. We performed hepatic resection of both segments. The tumors in SV and SVIII were pathologically diagnosed as HCC and ICC, respectively. Immunohistochemically, the HCC in SV was positive for carcinoembryonic antigen and negative for α-fetoprotein (AFP) and cytokeratin (CK), while the ICC in SVIII was negative for both AFP and CK. These observations confirmed the diagnosis of double primary liver cancer (HCC and ICC). Double primary liver cancer is extremely rare. We herein review previous reports of patients with a histological diagnosis of double primary liver cancer. Based on the findings of this case and the literature review, we speculate that the imaging findings of double primary hepatic cancer conform to the pathologic findings.