Unusual biliary myoepithelial carcinoma in liver-case report and immunohistochemical study.

Myoepithelial carcinoma is a well-known tumor of salivary gland, representing 1% of all salivary gland tumors. They have also been reported in other sites as skin/soft tissue, breast and lung. This paper reports a rare case of primary myoepithelial carcinoma in the liver, as well as discusses the findings of immunohistochemistry. The clinical manifestations, imaging characteristics, and histopathological changes of myoepithelial carcinoma in this case were described. The patient was a 33 years old female presented with a cystic tumor in the right lobe of the liver. As the liver tumor increased in size within six months, malignant neoplasm was suspected and thus anterior hepatic segmentectomy was performed. The mass composed of glandular-like structures and trabecular sheets of spindled shaped cells and epithelioid cells which were positive for myoepithelial markers. The tumor recurred within one year, in the left lobe of the liver and partial left lobe lobectomy was performed. The tumor resected showed similar histology to the primary tumor. Three months later, another recurrence was noted for which radiofrequency ablation was performed. This report presents a recurrent case of myoepithelial carcinoma in the liver and suggests the possibility of biliary origin of such tumor.

Radiation therapy for lymph node metastases from hepatocellular carcinoma.

BACKGROUND/AIMS: Recent improvements in the prognosis of patients with hepatocellular carcinoma (HCC) render the discovery and treatment of lymph node (LN) metastasis increasingly important. We retrospectively evaluated the treatment outcomes of radiation therapy (RT) for LN metastases from HCC. METHODOLOGY: Twenty-three patients with LN metastases from HCC underwent RT. A daily dose of 1.8-4 Gy was administered to deliver a total dose of 28-56 Gy, which was a biologic effective dose (BED) of 36-67.2 Gy10 (median 58.5 Gy10) with an alpha/beta ratio of 10. We evaluated predictive factors for local control and survival. RESULTS: A complete response and partial response were recorded for 5 and 14 patients, respectively. The response rate was 83%; it was significantly higher in patients who had received > or =58 Gy10 rather than <58 Gy10 (P = 0.014). The median survival time was 19 months. Univariate analysis revealed that the Child-Pugh's classification, status of the liver tumor, and LN metastasis site were significant factors for survival. Multivariate analysis showed that the status of the liver tumor was the only independent predictor of survival. CONCLUSIONS: RT is effective for the local control of LN metastases from HCC without a confirmed survival effect. RT doses greater than 58 Gy10 are required for a better local response.