A case of carcinosarcoma of the gallbladder with acute cholecystitis as the first diagnositic clue

• Published in: Tando Vol. 4; no. 4; pp. 499 - 504
• Main Authors: MTYAJI, Makoto, IWASE, Masanori, HOSHINO, Makoto, HAMADA, Sigeaki, OHIWA, Takayuki, TAKEUCHI, Toshihiko, NAKAMURA, Shinichi, MIZUNO, Kiyoshi, YOKOCHI, Makoto, IKEDA, Kazuo, SUZUKI, Kouichi, YAMAGUCHI, Yousuke, KITAMURA, Hiroshi, SAIDA, Yasuhiko, OHISHI, Masahiro
• Format: Journal Article
• Language: Japanese
• Published: Japan Biliary Association 1990
• Subjects: carcinosarcoma; 急性胆嚢炎; 胆嚢癌肉腫
• ISSN: 0914-0077; 1883-6879
• DOI: 10.11210/tando1987.4.4_499

A 79-year-old man was admitted to our hospital suffering from abdominal pain. Abdominal US and CT revealed features of acute cholecystitis and a large elevated lesion in the fundus of the gallbladder. Cholangioscopy after PTCCD showed this tumor occupying the gallbladder to have a whitish surface with partial hemorrhage. Biopsied specimens were histologically diagnosed as adenocarcinoma. Celiac angiography demonstrated a marked increase in the number and caliber of cystic arteries in the area of the tumor. Extended cholecystectomy was performed. Macroscopically the resected tumor presented as a peducnculated polyp, measuring 65×30×30mm, with a smooth, multinodular surface, and a solid and whitish cut section. Histopathology revealed the tumor to be composed of a mixture of spindle cell sarcoma and well differentiated adenocarcinoma elements. The sarcomatous component demonstrated stromal character on immunohistochemical analysis, but epithelial character on electron microscopic study. Therefore, the possibility of gallbladder carcinoma transformation to sarcoma was noted. This case may prove of assistance in elucidating the occurrence of carcinosarcoma.