A case of double cholangiolocellular carcinoma and hepatocellular carcinoma complicated with non-alcoholic steatohepatitis

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We report rare case of double cholangiolocellular carcinoma (CLC) and hepatocellular carcinoma complicated with non-alcoholic steatohepatitis (NASH). A 68-years old female with NASH was admitted to the hospital for examination and treatment of multiple hepatic tumors. Gd-EOB-DTPA enhanced MRI showed that tumor was located in segment 3, segment 4, and segment 6. The angiography and CT during angiography showed additional three tumors in segment 1 and segment 6. These tumors might be different tumor origin because of different imaging pattern. Operation was performed in segment 3 and 4, and RFA was performed in segment 1 and 6 because these tumors were diagnosed as hepatocellular carcinoma. Whitish tumor with clear margin which has no fibrous capsule was seen in tumor in segment 3. Pathologically, tumor in segment 3 showed CLC. Tumor in segment 4 was diagnosed as dysplastic nodule.