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ISSN 1561-3046 (Electronic)

2013, Number 3

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Rev Cub Med Mil 2013; 42 (3)

Carcinosarcoma of the gallbladder

Gutiérrez AZ, Jiménez GJJ, Leyva MU, Alarcón AI, Mera FA

Language: Spanish
References: 17
Page: 403-410
PDF size: 248.77 Kb.


ABSTRACT

Carcinosarcoma is an uncommon neoplasia of the gallbladder. Only about 40 cases have been reported in the literature worldwide. A case is presented of a female mulatto patient aged 72 who presented with abdominal pain centered on the right hypochondrium and the presence of skin xanthomas on several locations. The surgical act revealed that the gallbladder was adhering to the omentum and the duodenum, with thickening of the wall. Cholecystectomy was performed. Anatomopathological examination of the surgical piece corresponding to the gallbladder by the Pathological Anatomy service revealed that bile did not flow at its opening, and also calculus formation, a thickened wall and loss of mucosal felting. Microscopic observation revealed the presence of a tumor with malignant glandular differentiation areas and sarcomatoid stroma with fusocellular areas with numerous mitoses and a malignant chondroid matrix. Immunohistochemical examination was indicated with the presumed diagnosis of carcinosarcoma. The following results were obtained: positive cytokeratin CAM 5.2, positive focal carcinoembryonic antigen, positive vimentine, positive S-100 protein, and proliferating cell nuclear antigen elevated to more than 60%. The presence of the pleomorphic fusocellular component in the context of a moderately differentiated adenocarcinoma with areas of chondrosarcoma and the results of immunohistochemical analysis confirmed the diagnosis of carcinosarcoma of the gallbladder with a high rate of tumoral proliferation, implying an unfavorable prognosis and a short survival.


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