As rare condition, mucoepidermoid carcinoma may occur in liver although its etiology and pathogenesis is still unclear. by thoroughly microscopical inspection and the presence of mucin-producing cells confirmed by Alcian blue staining. Despite surgical excision and chemotherapy, the tumor showed very aggressive malignancy with tumor recurrence. The patient died shortly afterward, surviving 6?months after surgery. Due to its rarity and unique morphological features, mucoepidermoid carcinoma might be erroneously interpreted as squamous cell carcinoma by those who were not familiar with this condition in unusual locations. Therefore, removal of Cilengitide inhibition sufficient tissue from different portions of the lesion is essential for the surgeons and pathologists to make a precise diagnosis in the intraoperative histological examination. Virtual slide The virtual slide(s) for this article can be found here: Cilengitide inhibition http://www.diagnosticpathology.diagnomx.eu/vs/4956311271136060 strong class=”kwd-title” Keywords: Mucoepidermoid carcinoma, Intrahepatic tumor, Histological features, Differential diagnosis Background Mucoepidermoid carcinoma is a relatively common neoplasm of the salivary glands, which rarely occurs in other sites, including esophagus, anal canal, skin of the breast, lachrymal sac, thymus, thyroid gland, lung or uterine cervix [1-4]. Main intrahepatic mucoepidermoid carcinoma is usually rare tumor with only 17 cases explained in the English literature so far [5-17]. Because of its relative rarity in liver, its etiology has not yet been elucidated. Terminal intrahepatic bile ducts or biliary congenital cysts have been proposed as a possible origin [5,7,8,11]. Histologically, mucoepidermoid carcinoma is usually characterized by squamoid (epidermoid), mucus generating and cells of intermediate type. The proportion of different cell types and their architectural configuration varies in and between tumors. In general, it is not difficult to distinguish mucoepidermoid carcinoma from other tumors arising from salivary glands by histopathological examination because of its unique triphasic cellular morphology. However, mucoepidermoid carcinoma can be confused with squamous cell carcinoma when intermediate cells and epidermoid sometimes are prominent in the tumor. In particular, when the mucoepidermoid carcinoma occurs in an unusual site, a definite diagnosis might not be obtained without cautiously histological examination. We present a case of mucoepidermoid carcinoma occurring in an aged female patient that was misdiagnosed as cholangiocarcinoma and squamous cell carcinoma by both radiologic and intraoperative histopathological examination, respectively. Case presentation A 60-year-old Chinese woman, offered with a history of progressive jaundice, epigastric pain, anorexia, malaise, and excess weight loss for 1?month. She experienced no amazing Cilengitide inhibition medical or family history and had not experienced viral hepatitis. Clinical examination revealed a deeply jaundiced, emaciated woman without ascites. A hard, irregular liver was palpable 4?cm below the xiphisternum. The results of relevant laboratory studies were as follows: total protein, 7.6?g/dl; albumin, 3.5?g/dl; total bilirubin, 513 u mol/L; GOT, 35U; and GPT, 23U. -Fetoprotein (AFP) and carcinoembryonic antigen (CEA) were within the normal range and carbohydrate antigen 19-9 (CA19-9) was slightly increased to 50?mg/dl (normal range, 0-37?mg/dl). Hepatitis B viral antigen and hepatitis C antibody assays were unfavorable. Abdominal ultrasound and abdominal computed tomography (CT) both showed a large liver tumor lesion, 8?cm in diameter involving the left lobe of the liver with intrahepatic bile duct stone (Physique?1). Therefore, a preliminary diagnosis of LIPH antibody a cholangiocarcinoma of the liver was made, and the patient underwent left hepatic lobectomy with regional lymph node dissection. Intraoperative obtaining revealed an elastic hard tumor was found in the left lobe of the liver. The cut surface of the resected specimen showed an irregular, yellowish white solid tumor, measuring 8.5??6.5??3.0?cm, with central necrosis. The border between the tumor and normal liver tissue was indistinct (Physique?2A). A piece of tumor tissue was resected from the surface for intraoperative histological examination. Microscopically, the tumor was made up of nests of invasive epidermoid cells predominantly. A lot of the tumor cells were epidermoid with intercellular keratinization and bridges. There have been no specific mucin-producing cells in the cells (Shape?2B). Predicated on.