Fu RB, Dong XF. Diagnostic challenges and multidisciplinary management of primary adenosquamous carcinoma of the liver: A case report and review of literature. World J Gastrointest Surg 2026; 18(4): 115487 [DOI: 10.4240/wjgs.v18.i4.115487]
Corresponding Author of This Article
Xiao-Feng Dong, PhD, Department of Hepatobiliary, Pancreatic and Spleen Surgery, Guangxi Academy of Medical Sciences, The People’s Hospital of Guangxi Zhuang Autonomous Region, No. 6 Taoyuan Road, Qingxiu District, Nanning 530012, Guangxi Zhuang Autonomous Region, China. xfdong@gxams.org.cn
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Gastroenterology & Hepatology
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Case Report
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Apr 27, 2026 (publication date) through Apr 24, 2026
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World Journal of Gastrointestinal Surgery
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1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Fu RB, Dong XF. Diagnostic challenges and multidisciplinary management of primary adenosquamous carcinoma of the liver: A case report and review of literature. World J Gastrointest Surg 2026; 18(4): 115487 [DOI: 10.4240/wjgs.v18.i4.115487]
World J Gastrointest Surg. Apr 27, 2026; 18(4): 115487 Published online Apr 27, 2026. doi: 10.4240/wjgs.v18.i4.115487
Diagnostic challenges and multidisciplinary management of primary adenosquamous carcinoma of the liver: A case report and review of literature
Rui-Biao Fu, Xiao-Feng Dong
Rui-Biao Fu, Xiao-Feng Dong, Department of Hepatobiliary, Pancreatic and Spleen Surgery, Guangxi Academy of Medical Sciences, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530012, Guangxi Zhuang Autonomous Region, China
Author contributions: Fu RB and Dong SF contributed to manuscript writing and editing, data collection, data analysis, conceptualization and supervision. All authors have read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 82160589; and Guangxi Science and Technology Major Project, No. GuikeAA23073013.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Xiao-Feng Dong, PhD, Department of Hepatobiliary, Pancreatic and Spleen Surgery, Guangxi Academy of Medical Sciences, The People’s Hospital of Guangxi Zhuang Autonomous Region, No. 6 Taoyuan Road, Qingxiu District, Nanning 530012, Guangxi Zhuang Autonomous Region, China. xfdong@gxams.org.cn
Received: October 20, 2025 Revised: November 6, 2025 Accepted: February 5, 2026 Published online: April 27, 2026 Processing time: 187 Days and 20.6 Hours
Abstract
BACKGROUND
Adenosquamous carcinoma (ASC) of the liver is a rare and highly aggressive malignancy consisting of adenocarcinoma and squamous cell carcinoma components.
CASE SUMMARY
This case report describes the clinical features, diagnosis, treatment, and prognosis of a 61-year-old male patient with ASC of the liver. The patient was admitted to the hospital with right upper abdominal pain for 3 months, and abdominal computed tomography showed an 8-cm-diameter hypodense mass in the right left liver with central necrosis, initially misdiagnosed as a liver abscess based on imaging findings. Laboratory tests showed elevated carcinoembryonic antigen, cancer antigen 12-5 and cancer antigen 19-9, while alpha-fetoprotein was normal. After surgical resection, the pathological diagnosis was ASC, and immunohistochemical results showed cytokeratin (CK) 5/6 (+), CK7 (+), CK19 (+), and protein 40 (+). The patient received postoperative adjuvant therapy. Four months after the operation, liver-enhanced computed tomography did not suggest significant signs of recurrence. Ten months after the operation, multiple recurrent lesions within the liver were discovered.
CONCLUSION
This case highlights the diagnostic challenges and therapeutic complexity of ASC, underscoring the critical role of early diagnosis and multimodal treatment.
Core Tip: In this report, we present a case of primary hepatic adenosquamous carcinoma that was initially misdiagnosed as a liver abscess. We highlight how markedly elevated carcinoembryonic antigen and cancer antigen 19-9 prompted further investigation, leading to surgical resection and pathologic confirmation. Importantly, we demonstrate promising short-term outcomes using a multimodal approach combining radical surgery with adjuvant lenvatinib and envafolimab. Our experience underscores the necessity of histopathologic diagnosis for adenosquamous carcinoma and suggests that aggressive combined modality therapy may improve survival in this highly aggressive malignancy.
