Sarcomatoid hepatocellular carcinoma in a chronic hepatitis B infection patient without previous antitumor therapy: a case report and literature review

Abstract Background Sarcomatoid hepatocellular carcinoma (SHC) is rare. As a subtype of hepatocellular carcinoma (HCC), the clinical manifestations of SHC are similar to those of traditional HCC. Surgical resection is the main treatment, and postoperative adjuvant therapy can prolong the life of patients. However, the prognosis of sarcomatoid hepatocellular carcinoma is worse than that traditional HCC. Case presentation: we report a 69-year-old male patient with sarcomatoid hepatocellular carcinoma who was admitted to the hospital because of liver enlargement. Abdominal computed tomography revealed a mass in the right lobe of the liver (6.8 cm*4.8 cm). After middle hepatectomy, sarcomatous hepatocellular carcinoma was confirmed by histopathology and immunohistochemistry, and the patient was treated with transcatheter arterial chemoembolization(TACE) and targeted drugs after surgery. The patient died 26 months after surgery. Furthermore, we summarized the clinical, pathological, imaging and treatment of this type of tumor to further understand this solid tumor. Conclusion Sarcomatoid hepatocellular carcinoma is a rare subtype of hepatocellular carcinoma, Immunohistopathology is the main way to confirm the diagnosis. Due to the high malignancy and recurrence and metastasis rates of SHC, definite pathological diagnosis, suitable postoperative adjuvant therapy and strict follow-up management are helpful to improve the progression-free survival and survival rate of patients with SHC.