[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-detail-405682-en":59,"doc-seo-405682-105":80},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":5,"data":60},{"doc_id":61,"user_id":62,"nickname":63,"user_avatar":64,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":66,"doc_content":67,"file_id":68,"file_url":69,"file_type":70,"file_size":71,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":72,"language_code":73,"site_id":74,"html_lang":73,"table_of_contents":75,"faqs":76,"seo_title":77,"seo_description":66,"update_tm":78,"read_time":79,"preview_page_count":4},405682,13056703020460,"Valentina","https://ap-avatar.wpscdn.com/avatar/be000253dac470eee5d?_k=1778207105932848923","Rapidly Progressing Sarcomatoid Hepatocellular Carcinoma after Needle Biopsy and Radiofrequency Ablation","Rapidly progressing sarcomatoid hepatocellular carcinoma (SHC) is a rare primary liver malignancy with an unclear pathogenesis and a strong tendency to recur and worsen prognosis. Diagnosis before resection or autopsy is challenging because symptoms, serology, and imaging show no specific features. Needle biopsy in an 83-year-old woman after prior hepatocellular carcinoma therapies showed spindle-shaped mitotically active tumor cells with immunohistochemical findings consistent with SHC. The disease progressed rapidly after radiofrequency ablation, leading to death.","e-ISSN 1941-5923  \n© Am J Case Rep, 2023; 24: e939126 DOI: 10. 12659/AJCR.939126  \nReceived: 2022.12.01  \nAccepted: 2023.03.30  \nAvailable online: 2023.04.12  \nPublished: 2023.05.17  \nAuthors’ Contribution: Study Design A  \nData Collection B Statistical Analysis C Data Interpretation D Manuscript Preparation E Literature Search F Funds Collection G  \nABCDEFB  \nCD  \nCD  \nDG  \nCorresponding Author: Financial support: Conflict of interest:  \nRapidly Progressing Sarcomatoid Hepatocellular Carcinoma after Needle Biopsy and Radiofrequency Ablation  \nMasamichi Kimura  Ryo Matsuoka  \nKoji Nishikawa Jun Imamura Kiminori Kimura   \nMasamichi Kimura, [e-mail:](e-mail: masamichi_kimura@tmhp.jp)[ masamichi_kimura@tmhp.jp](e-mail: masamichi_kimura@tmhp.jp)  \nNone declared  \nNone declared  \nDepartment of Hepatology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan  \nPatient: Female, 83-year-old  \nFinal Diagnosis: Sarcomatoid hepatocellular carcinoma  \nSymptoms: Abdomen distension • edema  \nClinical Procedure: —  \nSpecialty: Gastroenterology and Hepatology  \nObjective: Unusual clinical course  \nBackground: Sarcomatoid hepatocellular carcinoma is a rare, primary malignant liver cancer. Its pathogenesis is unknown, but it often occurs in patients who have undergone repeated antitumor therapies for hepatocellular carcinoma. Sarcomatoid hepatocellular carcinoma is more likely to recur and has a worse prognosis than that of hepatocellular carcinoma. As no specific features have been identified in the symptoms, serological findings, or imaging findings, it is difficult to accurately diagnose the disease before surgical resection or autopsy.  \nCase Report: An 83-year-old woman was diagnosed with hepatocellular carcinoma 20 years ago. Radiofrequency ablation was initially performed. Thereafter, invasive, non-surgical treatments were repeated. The most recent treatment was 4 years ago, during which computed tomography suggested recurrent hepatocellular carcinoma. However, upon needle biopsy, histological examination revealed spindle-shaped tumor cells and actively mitotic cells. Immunohistochemical analysis showed negative results for Arginase-1, HepPar1, and Glypican3 and positive results for AE1/AE3, CK7, and vimentin. Therefore, sarcomatoid hepatocellular carcinoma was diagnosed, which was treated with radiofrequency ablation but progressed rapidly thereafter. Considering the rapid disease progression, the patient was treated conservatively. However, the patient’s general condition gradually deteriorated, resulting in death.  \nConclusions: Compared with hepatocellular carcinoma, sarcomatoid hepatocellular carcinoma is more prone to recurrence and has a poorer prognosis. Therefore, aggressive surgical resection seems to be the most appropriate treatment for sarcomatoid hepatocellular carcinoma at present. Additional hepatic resection or follow-up imaging in a short period should be considered at the time of diagnosis of sarcomatoid hepatocellular carcinoma by biopsy, considering the risk of seeding or recurrence.  \nKeywords: alpha-Fetoproteins • Radiofrequency Ablation  \nFull-text PDF: [https://www.amjcaserep.com/abstract/index/idArt/939126](https://www.amjcaserep.com/abstract/index/idArt/939126)  \n1658  —  4  20  \nPublisher’s note: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher  \nThis work is licensed under Creative Common AttributionNonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)  \ne939126-1  \nIndexed in: [PMC] [PubMed] [Emerging Sources Citation Index (ESCI)][Web of Science by Clarivate]  \n[Kimura M. et](Kimura M. et) al: Sarcomatoid hepatocellular carcinoma © Am J Case Rep, 2023; 24: e939126  \nBac","cbCaifUKuq0SspMt","https://ap.wps.com/l/cbCaifUKuq0SspMt","pdf",1825558,"English","en",105,"# Case Report\n## Background\n## Case Report\n## Conclusions","[{\"question\":\"Why is diagnosing sarcomatoid hepatocellular carcinoma before surgery difficult?\",\"answer\":\"Symptoms, serology, and imaging often lack specific features, so accurate diagnosis is hard to achieve before surgical resection or autopsy.\"},{\"question\":\"What key pathology findings supported the SHC diagnosis?\",\"answer\":\"Needle biopsy showed spindle-shaped tumor cells with actively mitotic cells, and immunohistochemistry was negative for Arginase-1, HepPar1, and Glypican3 but positive for AE1/AE3, CK7, and vimentin.\"},{\"question\":\"How did the patient’s condition change after radiofrequency ablation?\",\"answer\":\"Despite treatment with radiofrequency ablation, the carcinoma progressed rapidly, the patient’s general condition gradually deteriorated, and death occurred.\"}]","Rapidly Progressing Sarcomatoid Hepatocellular Carcinoma after Needle Biopsy and Radiofrequency Ablation | PDF",1790561418,15,{"code":4,"msg":81,"data":82},"ok",{"site_id":74,"language":73,"slug":83,"title":65,"keywords":84,"description":66,"schema_data":85,"social_meta":139,"head_meta":141,"extra_data":143,"updated_unix":144},"rapidly-progressing-sarcomatoid-hepatocellular-carcinoma-after-needle-biopsy-and-radiofrequency-ablation","",{"@graph":86,"@context":138},[87,101,121],{"@type":88,"itemListElement":89},"BreadcrumbList",[90,94,96,99],{"item":91,"name":92,"@type":93,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":95,"name":9,"@type":93,"position":14},"https://docshare.wps.com/document/",{"item":97,"name":35,"@type":93,"position":98},"https://docshare.wps.com/document/healthcare/",3,{"item":100,"name":65,"@type":93,"position":19},"https://docshare.wps.com/document/rapidly-progressing-sarcomatoid-hepatocellular-carcinoma-after-needle-biopsy-and-radiofrequency-ablation/405682/",{"url":100,"name":65,"@type":102,"image":103,"author":108,"headline":65,"publisher":110,"fileFormat":113,"inLanguage":73,"description":66,"dateModified":114,"datePublished":115,"encodingFormat":113,"isAccessibleForFree":116,"interactionStatistic":117},"DigitalDocument",{"url":104,"@type":105,"width":106,"height":107},"https://docshare.wps.com/thumbnails/rapidly-progressing-sarcomatoid-hepatocellular-carcinoma-after-needle-biopsy-and-radiofrequency-ablation/405682.png","ImageObject",300,407,{"name":63,"@type":109},"Person",{"url":91,"name":111,"@type":112},"DocShare","Organization","application/pdf","2026-11-07","2026-09-28",true,{"@type":118,"interactionType":119,"userInteractionCount":29},"InteractionCounter",{"@type":120},"ViewAction",{"@type":122,"mainEntity":123},"FAQPage",[124,130,134],{"name":125,"@type":126,"acceptedAnswer":127},"Why is diagnosing sarcomatoid hepatocellular carcinoma before surgery difficult?","Question",{"text":128,"@type":129},"Symptoms, serology, and imaging often lack specific features, so accurate diagnosis is hard to achieve before surgical resection or autopsy.","Answer",{"name":131,"@type":126,"acceptedAnswer":132},"What key pathology findings supported the SHC diagnosis?",{"text":133,"@type":129},"Needle biopsy showed spindle-shaped tumor cells with actively mitotic cells, and immunohistochemistry was negative for Arginase-1, HepPar1, and Glypican3 but positive for AE1/AE3, CK7, and vimentin.",{"name":135,"@type":126,"acceptedAnswer":136},"How did the patient’s condition change after radiofrequency ablation?",{"text":137,"@type":129},"Despite treatment with radiofrequency ablation, the carcinoma progressed rapidly, the patient’s general condition gradually deteriorated, and death occurred.","https://schema.org",{"og:url":100,"og:type":140,"og:title":65,"og:site_name":111,"og:description":66},"article",{"robots":142,"canonical":100},"index,follow",{"doc_id":61,"site_id":74},1790697205]