Gallbladder Carcinosarcoma: A Case Report and Literature Review

Carcinosarcoma of the gallbladder is a rare malignancy characterized by both malignant epithelial and mesenchymal components. The clinical behavior of this tumor is extremely aggressive. Only 26 cases have been reported in the world literature to date. We report the case of a 64-year-old woman who h...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2005-07, Vol.9 (6), p.818-821
Main Authors: Huguet, Kevin L., Hughes, Christopher B., Hewitt, Winston R.
Format: Article
Language:English
Subjects:
Biopsy, Needle
Carcinosarcoma
Carcinosarcoma - diagnosis
Carcinosarcoma - pathology
Carcinosarcoma - surgery
Colectomy - methods
Combined Modality Therapy
Female
Follow-Up Studies
Gallbladder
Gallbladder Neoplasms - diagnosis
Gallbladder Neoplasms - pathology
Gallbladder Neoplasms - surgery
Hepatectomy - methods
Humans
Immunohistochemistry
Laparotomy - methods
Medical diagnosis
Middle Aged
neoplasm
Neoplasm Invasiveness - pathology
Neoplasm Staging
Neoplasms, Multiple Primary - pathology
Neoplasms, Multiple Primary - surgery
Pancreatectomy - methods
Risk Assessment
spindle cell sarcoma
squamous cell carcinoma
Tomography, X-Ray Computed - methods
treatment
Treatment Outcome
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Summary:Carcinosarcoma of the gallbladder is a rare malignancy characterized by both malignant epithelial and mesenchymal components. The clinical behavior of this tumor is extremely aggressive. Only 26 cases have been reported in the world literature to date. We report the case of a 64-year-old woman who had fever associated with a right upper quadrant mass. An exploratory laparotomy through a right upper quadrant incision was performed at another institution, and the patient was thought to have severe acute cholecystitis that would require additional antibiotic therapy before attempted resection. She was referred to our center, where abdominal CT showed a 6.4 × 8.2 cm pericholecystic mass involving the hepatic flexure of the colon. The patient underwent cholecystectomy and hepatic wedge resection, pancreaticoduodenectomy, and right hemicolectomy. Pathologic examination of the surgical specimen revealed two histologic components consisting of squamous cell carcinoma and spindle cell sarcoma of gallbladder origin, consistent with carcinosarcoma. All seven lymph nodes in the pancreaticoduodenectomy specimen were negative for tumor. We present this case and a review of the literature and current treatment recommendations.
ISSN:1091-255X
1873-4626
DOI:10.1016/j.gassur.2004.12.009