Page 102 - ARNM-3-3

Advances in Radiotherapy &

Nuclear Medicine

CASE REPORT
A case report of sarcomatoid hepatocellular

carcinoma treated multimodality

Cam Phuong Pham 1,2,3 , Quang Hien Le * , Binh Duong Nguyen 3 ,
1,3
Trong Khoa Mai 1,2 , Van Thai Pham 1,3 , and Thi Hong Lieu Nguyen 4
1 The Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam
2 Department of Oncology and Nuclear Medicine, University of Medicine and Pharmacy, Vietnam
National University, Hanoi, Vietnam
3 Department of Nuclear Medicine, Hanoi Medical University, Hanoi, Vietnam
4 Pathology and Cytology Center, Bach Mai Hospital, Hanoi, Vietnam

Abstract

Sarcomatoid hepatocellular carcinoma (SHC) is a rare and highly aggressive variant
of hepatocellular carcinoma (HCC), characterized by high malignancy, frequent
recurrence, and poor prognosis. Definitive diagnosis is based on histopathological
criteria to differentiate it from HCC and other malignant tumors in the liver. At present,
there is no standardized treatment; surgery remains the primary therapeutic option,
while other treatments show only modest effectiveness. We herein present a clinical
case of a male patient diagnosed with SHC who experienced multiple recurrences
and underwent multimodal treatment, including transarterial chemoembolization,
*Corresponding author: surgery, and systemic chemotherapy.
Quang Hien Le
(lequanghien@hmu.edu.vn)
Keywords: Sarcomatoid hepatocellular carcinoma; Recurrence; Multimodality treatment
Citation: Pham CP, Le QH,
Nguyen BD, et al. A case report
of sarcomatoid hepatocellular
carcinoma treated multimodality.
Adv Radiother Nucl Med. 1. Introduction
2025;3(3):94-99.
doi: 10.36922/ARNM025220024 Sarcomatoid carcinoma is a relatively rare malignant tumor characterized by the
Received: May 31, 2025 coexistence of epithelial and mesenchymal cells. This tumor can arise in various organs,
1
Revised: June 20, 2025 with the lung being the most susceptible. Sarcomatoid hepatocellular carcinoma (SHC)
is an uncommon and aggressive variant of hepatocellular carcinoma (HCC), accounting
Accepted: July 21, 2025 for <2% of all primary liver cancers. The diagnosis of SHC is based on postoperative
Published online: August 7, 2025 histopathology, as there is no specific immunohistochemical biomarker for this
Copyright: © 2025 Author(s). pathology. SHC is associated with a poor prognosis due to its high rates of recurrence
This is an Open-Access article and distant metastasis.
distributed under the terms of the
Creative Commons Attribution A higher incidence of SHC is commonly reported in males, and the tumor is
License, permitting distribution, frequently associated with chronic hepatitis B virus or hepatitis C virus infections.
and reproduction in any medium, Despite the elevated levels of alpha-fetoprotein in the affected patients, this non-uniform
provided the original work is
properly cited. increase is not adequate as a valid marker for early diagnosis.
Publisher’s Note: AccScience At the molecular level, SHC has been associated with several genetic alterations,
Publishing remains neutral with including TP53 mutations, c-MYC amplification, and activation of the RAS/RAF
regard to jurisdictional claims in
published maps and institutional signaling pathway. These findings suggest a distinct oncogenic mechanism compared to
affiliations. conventional HCC.

Volume 3 Issue 3 (2025) 94 doi: 10.36922/ARNM025220024