Objective  To discusse the clinical features of sarcomatoid hepatocellular carcinoma to improve the understanding of diagnosis and treatment for sarcomatoid hepatocellular carcinoma.

  Methods  Data including clinical features and follow-up from 8 patients admitted in Tianjin Medical University Cancer Institute and Hospital from January 2009 to April 2014 were retrospectively analyzed.

  Results  The average age of all patients was 56.6 years old, and the male-to-female ratio was 3:1. Preoperative CT or MRI showed specific characteristics but it was difficult to confirm diagnosis. Pathological and immunohistochemical examination revealed an expressed epithelial-like phenotype. All 8 patients had advanced local tumor invasion and high lymph node metastasis rates. These patients received surgery, and the median survival time was 10.8 months (3 months to 35 months).

  Conclusion  Diagnosis of sarcomatoid hepatocellular carcinoma mainly depended on postoperative pathological examination. Immunohistochemistry was beneficial for sarcomatoid hepatocellular carcinoma diagnosis and differential diagnosis. Surgical treatment prolonged survival time, but the overall prognosis remained poor.