Combined intrahepatic cholangiocarcinoma and hepatocellular carcinoma

Louise C. Connell, James J. Harding, Jinru Shia, Ghassan K. Abou-Alfa


Hepatocellular carcinoma (HCC), the fifth most common cancer globally and third leading cause of cancer-related mortality is a heterogeneous disease with a highly variable clinical course. The inherent biological diversity of hepatic carcinomas may hinder therapeutic decision making and prognostication for patients. One distinct, albeit rare, subtype of primary hepatic carcinoma is combined intrahepatic cholangiocarcinoma and hepatocellular carcinoma (cHCC-ICC), which carries an overall worse prognosis than either HCC or intrahepatic cholangiocarcinoma (ICC) alone. cHCC-ICC is a primary hepatic neoplasm containing unequivocal elements of both HCC and ICC. This review will focus on understanding further the histopathology of this unique tumor type, current treatment approaches and prognoses for this rare patient population.