A case of synchronous double primary combined hepatocellular-cholangiocarcinoma complicated with gallbladder adenocarcinoma - a rare case report

Sep 22, 2026

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Synchronous combined hepatocellular-cholangiocarcinoma (cHCC-CCA) complicated with gallbladder adenocarcinoma represents an extremely rare multiple primary cancer scenario. A 73-year-old woman presented with right upper abdominal distending pain, nausea, and weight loss. Contrast-enhanced CT and liver-specific contrast-enhanced MRI identified a segment S4 space-occupying liver lesion and a gallbladder wall nodular lesion. Open surgery and postoperative pathology with immunohistochemistry confirmed cHCC-CCA in the liver and moderately differentiated adenocarcinoma in the gallbladder, with negative resection margins. After MDT review, the synchronous double primary diagnosis was confirmed, and symptoms improved.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Introduction

Patient information

Physical examination

Laboratory examinations

Imaging examinations

Discussion

TYPE Case Report PUBLISHED 04 May 2026 DOI 10.3389/fonc.2026.1802177 OPEN ACCESS EDITED BY Alessandro Gambella, University of Genoa, Italy REVIEWED BY Barbara Frittoli, ASST Spedali Civili, Italy Anju Shukla, Sahara Hospital, India *CORRESPONDENCE Tianxiang Liu [tianxiangliuliu@163.com](tianxiangliuliu@163.com) †These authors have contributed equally to this work RECEIVED 02 February 2026 REVISED 03 April 2026 ACCEPTED 10 April 2026 PUBLISHED 04 May 2026 CITATION Wang X, Yang L, Jian H, Gao X and Liu T (2026) A case of synchronous double primary combined hepatocellularcholangiocarcinoma complicated with gallbladder adenocarcinoma: a rare case report. Front. Oncol. 16:1802177 . doi: 10.3389/fonc.2026.1802177 COPYRIGHT © 2026 Wang, Yang, Jian, Gao and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. A case of synchronous double primary combined hepatocellularcholangiocarcinoma complicated with gallbladder adenocarcinoma: a rare case report Xiangfei Wang 1,2†, Linru Yang 1,2†, Haiming Jian 1,2, Xiaoru Gao 1,3 and Tianxiang Liu 2* 1 First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou, China, 2 Department of Surgical Oncology, Gansu Provincial People’s Hospital, Lanzhou, China, 3 First Department of Radiation Oncology, Gansu Provincial People’s Hospital, Lanzhou, China Multiple Primary Cancers (MPCs), especially synchronous combined hepatocellular-cholangiocarcinoma (cHCC-CCA) complicated with gallbladder adenocarcinoma, are extremely rare clinically. This case report discusses a 73-year-old female patient presenting with distending pain in the right upper abdomen, nausea, and weight loss. Contrast-enhanced abdominal computed tomography (CT) and liver-speciﬁc contrast-enhanced magnetic resonance imaging (MRI) revealed a space-occupying lesion in segment S4 of the liver (considered cholangiocarcinoma) and a nodular lesion in the gallbladder wall (considered neoplastic lesion) . The patient underwent open surgery, and postoperative pathology and immuno histochemical examinations conﬁr med: the left hemihepatic lesion was cHCC-CCA (90% moderately differentiated cholangiocarcinoma and 10% moderately differentiated hepatocellular carcinoma), the gallbladder lesion was moderately differentiated adenocarcinoma, and no cancerous tissue involvement was found at the resection margins of the liver and gallbladder. After postoperative multidisciplinary team (MDT) discussion, the diagnosis of synchronous double primary tumors of the liver and gallbladder was conﬁrmed. The patient recovered well after surgery, and the abdominal pain symptoms were signiﬁcantly improved. This is the ﬁrst reported case of synchronous double primary cHCC-CCA complicated with gallbladder adenocarcinoma at home and abroad. KEYWORDS case report, combined hepatocellular-cholangiocarcinoma, gallbladder adenocarcinoma, multiple primary cancers, synchronous double primary tumors Frontiers in Oncology 01 [frontiersin.org](frontiersin.org) Introduction Multiple Primary cancers (MPCs) refer to two or more mutually independent malignant tumors occurring simultaneously or within an interval of 6 months in the same patient (1) . In recent years, with the improvement of the popularity of national health check-ups and the advancement of imaging and pathological diagnosis technologies, the detection rate of MPCs has gradually increased. However, clinical cases of MPCs are still rare, especially synchronous double primary tumors involving the liver and gallbladder (2, 3) . The liver is a

FAQs

What rare condition does the case report focus on?

The report focuses on synchronous double primary tumors combining combined hepatocellular-cholangiocarcinoma (cHCC-CCA) with gallbladder adenocarcinoma.

How was the diagnosis established?

The diagnosis was confirmed through contrast-enhanced CT/MRI findings, followed by open surgery and postoperative pathology plus immunohistochemical examinations demonstrating specific tumor types and negative resection margins.

What were the main presenting symptoms and treatment outcome?

The patient presented with right upper abdominal distending pain, nausea, and weight loss. After surgery and multidisciplinary team assessment, the patient recovered well with abdominal pain symptoms significantly improved.

Sep 22, 2026

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