Combined Hepatocellular-Cholangiocarcinoma Associated With Radiofrequency Ablation for Hepatocellular Carcinoma
Bibliographic record
Abstract
The patient was a 70-year-old male with liver cirrhosis associated with viral hepatitis C. He underwent radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) four times of in the 3 years prior to this reported event. Although he was closely followed after RFA by imaging every 3 - 4 months, a hypovascular and ill-defined tumor was revealed in segment IV of the liver by enhanced CT. The tumor expanded from the necrotic area associated with RFA performed 2 years prior. Because the tumor rapidly enlarged and was accompanied by a progressive tumor thrombus that filled the left portal vein, left hepatectomy was urgently performed. Histopathological examination of the resected specimen demonstrated that the tumor was mostly composed of moderately differentiated HCC. However, it also included obvious glandular structures with mucin production, which were immunohistochemically positive for both cytokeratin 7 and 19. These features are characteristic of cholangiocarcinoma; therefore the tumor was diagnosed as an uncommon combined hepatocellular-cholangiocarcinoma (cHCC-CC). From both pathological investigation and retrospective review of imaging results, the present cHCC-CC was presumed to derive from a locally recurring tumor with morphologic changes to the biliary phenotype induced by RFA for HCC. Both distant and intrahepatic metastases appeared 4 months after surgery and the patient died of cancer 15 months after surgery in spite of anti-cancer treatments. J Med Cases. 2016;7(1):28-32 doi: http://dx.doi.org/10.14740/jmc2387w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".