Hepatic Undifferentiated Carcinoma With Osteoclast Like Giant Cell With Dominant Intraductal Growth: A Case Report With Literature Review

Abstract

Undifferentiated carcinoma with osteoclast-like giant cells is extremely rare in the liver. Here, we report a tumor with dominant intraductal growth. The unique growth pattern has never been reported before. A 73-year-old female patient presented intermittent right upper quadrant abdominal pain accompanied by fever and general weakness for 1 month. Imaging study revealed an intraductal lesion in the dilated large bile duct. Histologically, the tumor showed predominantly undifferentiated carcinoma with osteoclast-like giant cells, associated with high-grade biliary intraepithelial neoplasia and minor foci of adenocarcinoma. A KRAS codon 61 mutation was detected, supporting the epithelial origin of undifferentiated carcinoma with osteoclast-like giant cells. This tumor not only adds to the limited documented instances of undifferentiated carcinoma with osteoclast-like giant cells in the liver but also demonstrates that the development of an undifferentiated component might occur in a low stage tumor, which is typically considered a late stage in tumor progression.