Hepatic Carcinoma With Epithelial-Myoepithelial Differentiation and Metachronous Intrahepatic Recurrence Following Curative Resection: A Rare Case Report.

Authors

Ryo Nagao, Tomoyuki Abe, Masateru Yamamoto, Yuki Imaoka, Naruhiko Honmyo, Seiichi Shimizu, Shintaro Kuroda, Hiroyuki Tahara, Masahiro Ohira, Kentaro Ide, Tsuyoshi Kobayashi, Tetsuya Nakagiri, Koji Arihiro, Hideki Ohdan

Published in

Hepatology research : the official journal of the Japan Society of Hepatology. Jul 21, 2026. Epub Jul 21, 2026.

Abstract

Epithelial-myoepithelial carcinoma (EMC), a malignant tumor with biphasic epithelial and myoepithelial differentiation, is typically a salivary gland neoplasm. Contrastingly, myoepithelial carcinoma (MEC) predominantly comprises myoepithelial cells. In salivary gland pathology, biphasic ductal tumors are classified as EMC, even with a predominant myoepithelial component. Primary hepatic tumors showing myoepithelial and epithelial-myoepithelial differentiation are rare, with uncertain definition and clinical behavior owing to limited reported hepatic carcinoma with MEC/EMC spectrum cases. Here, we report a unique case with intrahepatic recurrence that was successfully managed with repeat hepatectomies.
A 66-year-old woman presented with pain in the right hypochondrium. Imaging revealed a 13 cm tumor in the right hepatic lobe, and biopsy suggested squamous cell carcinoma. After portal vein embolization, right trisectionectomy was performed. Histopathology revealed a biphasic structure with duct-forming epithelial cells surrounded by myoepithelial cells, confirming hepatic carcinoma with epithelial-myoepithelial differentiation. After 2 years, multiple intrahepatic recurrences without extrahepatic disease were detected and repeat hepatectomies were performed. The patient remains recurrence-free 1 year post-reoperation.
Hepatic carcinoma with epithelial-myoepithelial differentiation is rare, with uncertain definition and clinical behavior. Careful exclusion of extrahepatic primaries, detailed immunophenotyping, and long-term surveillance are essential. Repeat hepatectomies may be a curative option for intrahepatic recurrence in selected patients.

PMID:
42478337
Bibliographic data and abstract were imported from PubMed on 21 Jul 2026.

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