A Case of True Carcinosarcoma of the Middle Portion of the Bile Duct Composed Leiomyosarcoma and Adenosquamous Carcinoma

Tadasu Mori, Shigeo Souda¹⁾, Masato Ohshima²⁾, Riichiro Nezu¹⁾ and Yukinobu Yoshikawa¹⁾

Department of Surgery, Osaka Prefectural Habikino Hospital
Department of Surgery¹⁾ and Pathology²⁾ , Nissay Hospital

A 70-year-old man was referred to our hospital for further examination of obstructive jaundice. Percutaneus transhepatic cholangiodrainage (PTCD) and sequential imaging methods were performed, and a diagnosis of cholangioma of the middle common bile duct was made. Bile cytology and biopsy of the tumor through the PTCD tube revealed squamous cell carcinoma, and pancreaticoduodenectomy was performed. The tumor was the papillary type, and 10×28 mm in size. Histological examination showed that nonepithelial spindle cells occupied most of the papillary tumor, and that adenocarcinoma, squamous cell carcinoma, and squamous cell metaplasia components were present in a part of surface and interior of the tumor. Immunohistochemical study showed that the nonepithelial spindle cell tumor had numerous mitotic figures and was positive for vimentin, smooth muscle antigen (SMA), and actin. We report an extremely rare case of carcinosarcoma of the bile duct.

Key words
carcinosarcoma of bile duct, adenosquamous carcinoma of bile duct, leiomyosarcoma

Reprint requests
Tadasu Mori Department of Surgery, Osaka Prefectural Habikino Hospital Habikino 3-7-1, Habikino city, 583-8588 JAPAN

Accepted
June 28, 2000

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