SHM Converge Scientific Abstract ePoster Gallery-Hepatic Carcinosarcoma and Chronic Lymphocytic Leukemia Involving the Liver

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This case report describes the first known instance of <strong>simultaneous hepatic carcinosarcoma (HCS) and chronic lymphocytic leukemia (CLL) involving the liver</strong>. HCS is an exceptionally rare liver cancer containing both carcinoma and sarcoma components, while CLL is the most common leukemia in North America.

The patient was a 60-year-old Hispanic man with a history of <strong>treated, non-cirrhotic hepatitis C</strong> and <strong>indolent Rai stage 0 CLL</strong> with an ATM gene mutation. He presented with <strong>progressive abdominal pain, anorexia, and 40-pound weight loss</strong> over three months, along with cachexia, jaundice, and hepatosplenomegaly. Labs showed leukocytosis from known CLL, mild anemia, coagulopathy, low albumin, and elevated AST. CT imaging revealed <strong>large heterogeneous hepatic masses</strong> involving nearly the entire right hepatic lobe, along with suspicious abdominal lymph nodes and a pancreatic-region mass. Liver biopsy unexpectedly demonstrated <strong>both HCS and CLL infiltration</strong>.

Because of the extensive disease, the patient was <strong>not a candidate for surgery or radiation</strong> and declined systemic chemotherapy, choosing comfort-focused care. He died two months later.

The discussion emphasizes that HCS has been reported in only a small number of cases and may arise de novo or in association with chronic liver disease, including hepatitis B or C. Although this patient had achieved sustained viral suppression after hepatitis C treatment, residual risk of liver cancer can still persist. CLL is also associated with an increased risk of second malignancies, likely due to impaired immune surveillance. However, liver biopsy is not routinely part of standard CLL evaluation and typically does not alter CLL management unless liver abnormalities are present.

Overall, the report highlights the rare coexistence of two malignancies in the liver and underscores the importance of evaluating new liver lesions in patients with prior hepatitis C and CLL.

Asset Subtitle

Arlene Yu

Meta Tag

Author List Arlene Yu, Crystal Antoine-Pepeljugoski

Category Clinical Vignettes

Concept Hepatic Carcinosarcoma

Concept Chronic Lymphocytic Leukemia

Concept Hepatitis C

Concept Primary Liver Malignancy

Concept Carcinoma

Distinguished Non-Finalist

Presenter Organization Jacobi Medical Center

Presenting Author Arlene Yu

Track Adult

Keywords

hepatic carcinosarcoma

chronic lymphocytic leukemia

liver involvement

case report

hepatitis C

liver biopsy

hepatic masses

coexisting malignancies

hepatosplenomegaly

cachexia

Hepatic Carcinosarcoma

Chronic Lymphocytic Leukemia

Hepatitis C

Primary Liver Malignancy

Carcinoma