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

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 immunohistochemical examinations confirmed: 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.