Undifferentiated high-grade pleomorphic sarcoma of the common bile duct: A case report and review of literature

Undifferentiated pleomorphic sarcoma (UPS) is a rare malignant mesenchymal tumor with a poor prognosis. It mainly occurs in the extremities, trunk, head and neck, and retroperitoneum regions. Owing to the lack of specific clinical manifestations and imaging features, UPS diagnosis mainly depends on...

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Bibliographic Details
Published inWorld journal of gastrointestinal oncology Vol. 16; no. 5; pp. 2253 - 2260
Main Authors Zheng, Li-Ping, Shen, Wen-Yan, Hu, Chun-Dong, Wang, Chun-Hua, Chen, Xu-Jian, Wang, Jing, Shen, Yi-Yu
Format Journal Article
LanguageEnglish
Published China Baishideng Publishing Group Inc 15.05.2024
Subjects
Case Report
Immunohistochemistry
Soft tissue sarcoma
Common bile duct
Case report
Extrahepatic bile duct
Undifferentiated pleomorphic sarcoma
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Summary:Undifferentiated pleomorphic sarcoma (UPS) is a rare malignant mesenchymal tumor with a poor prognosis. It mainly occurs in the extremities, trunk, head and neck, and retroperitoneum regions. Owing to the lack of specific clinical manifestations and imaging features, UPS diagnosis mainly depends on pathological and immunohistochemical examinations for exclusive diagnosis. Here we report an extremely rare case of high-grade UPS in the common bile duct (CBD). There are limited available data on such cases. A 70-year-old woman was admitted to our department with yellow eyes and urine accompanied by upper abdominal distending pain for 2 wk. Her laboratory data suggested significantly elevated hepatorenal function levels. The imaging data revealed calculous cholecystitis, intrahepatic and extrahepatic bile duct dilation with extrahepatic bile duct calculi, and a space-occupying lesion at the distal CBD. After endoscopic biliary stenting and symptomatic support therapy, CBD exploration and biopsy were performed. The frozen section indicated malignant spindle cell tumor of the CBD mass, and further radical pancreaticoduodenectomy was performed. Finally, the neoplasm was diagnosed as a high-grade UPS combined with the light-microscopic morphology and immunohistochemical results. This extremely rare case highlighted the need for increasing physicians' vigilance, reducing the odds of misdiagnosis, and providing appropriate treatment strategies.
Bibliography:Co-first authors: Li-Ping Zheng and Wen-Yan Shen.
Supported by the People’s Livelihood Science and Technology Innovation Project of the Bureau of Science and Technology of Jiaxing City, No. 2021AD30091.
Corresponding author: Yi-Yu Shen, MD, Chief Physician, Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, No. 1518 Huancheng North Road, Jiaxing 314000, Zhejiang Province, China. drzlping@126.com
Author contributions: Zheng LP, Wang J and Shen YY concepted and designed the case report; Zheng LP, Shen WY and Hu CD collected the clinicopathologic data of the patient; Shen WY and Wang CH provided and explained the pathological pictures; Zheng LP, Shen WY, Chen XJ, Wang J and Shen YY analyzed the data; Zheng LP, Wang J and Shen YY wrote the manuscript; All the authors have read and approved the final manuscript. Zheng LP conceived, designed the case, collected and analyzed the data, and wrote the first draft of the manuscript. Shen WY was responsible for the collection and processing of tissue specimens, as well as pathological diagnosis. Both authors have made vital and indispensable contributions to the completion of the case and are therefore eligible to be co-first authors of the paper. As co-corresponding authors, Wang J and Shen YY played an important and indispensable roles in case design, data analysis and manuscript preparation.
Co-corresponding authors: Jing Wang and Yi-Yu Shen.
ISSN:1948-5204
1948-5204
DOI:10.4251/wjgo.v16.i5.2253