• Jingyi Li, Xizhuang Gao, Kun Zhao, Xiangzheng Meng, Shuwei Liu, and Jian Zhang.
• Clinical Medical College of Jining Medical University, Jining Medical University, Jining, Shandong, P.R. China.
• Medicine (Baltimore). 2024 Jan 26; 103 (4): e37013e37013.

RationaleSarcomatoid hepatocellular carcinoma (SHC) is an uncommon variant of hepatocellular carcinoma (HCC), characterized by HCC features combined with sarcomatoid histology and manifestations. The simultaneous occurrence of HCC and hepatosarcomatoid carcinoma is infrequent. This report presents a distinctive instance of HCC coexisting with hepatic sarcomatoid carcinoma in a 56-year-old male. The case exhibits an unusual clinical presentation, diagnosis, treatment, and prognosis. Through the presentation of this case, we aspire to contribute novel concepts to shape forthcoming strategies encompassing SHC diagnosis and treatment.Patient ConcernsThe 56-year-old male patient was admitted to the hospital, due to discovering a hepatic mass lasting for over 2 months.DiagnosesUltimately, combined hepatocellular and SHC diagnosis was conclusively confirmed through histopathological and imaging examinations.InterventionIn this case, our approach encompassed hepatectomy coupled with ultrasound-guided radiofrequency ablation for HCC. Intraoperative ultrasound localization was employed for accurate tumor identification, followed by postoperative hepatic artery embolization to facilitate meticulous tumor resection.OutcomesHe underwent hepatic arteriography chemoembolization treatment and is currently stable, experiencing regular chemotherapy follow-up visits.LessonsThe presence of distinct tumor types concurrently can influence treatment choices and prognosis. Given the intricate nature of this condition, crafting an optimal treatment strategy necessitates the incorporation of variables such as the patient age, tumor characteristics, liver function, and other pertinent factors.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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