Esophageal metastasis of stem cell-subtype hepatocholangiocarcinoma: Rare presentation of a rare tumor

Figure 1 Endoscopic appearance of the elevated lesion in the esophagus. Upper digestive endoscopy showed a 10-cm polypoid tumor at 30 cm from incisors.

Figure 2 Computed tomography scan and magnetic resonance imaging scan imaging. Axial-enhanced computed tomography scans with arterial (A) and 5-min delayed times (B). Corresponding axial enhanced MRI in T1-weighted sequence with fat suppression (C and D). Tumor of the junction of the segments VIII-VII combined the double imaging features with peripheral arterial contrast enhancement (white arrow) and secondary wash out (black arrow) (HCC part) and a late fibrous contrast enhancement of the central part (white asterisk) (ICC part). MRI was performed at 2-mo intervals and demonstrated a second tumor with comparable behavior in segment IV. CT: Computed tomography; MRI: Magnetic resonance imaging.

Figure 3 Histological and immunohistochemical appearance of hepatic lesions. A: Combined hepatocellular cholangiocarcinoma, stem cell features, intermediate cell-subtype with underlying cirrhosis; B: The tumor is composed of small tumor cells arranged in bays, with some ill-defined glands; C: Cells express both markers of hepatocyte cells (Her Par1); D: Markers of biliary cells (cytokeratin 19).