A Case of True Carcinosarcoma with Gastrointestinal Stromal Tumor Probably arising from the Lower Bile Duct

Tomotaka Yasumura, Daisuke Yamaguti, Shin Saida, Akiharu Yagawa and Toshifusa Ozawa

Department of Surgery, Yamanashi Hospital of Social Insurance

A-69-year-old woman was referred to our hospital with the chief complaint of right hypochondrial pain. Detailed examination revealed a tumor in the duodenal lumen arising from the lower part the bile duct, however, a definitive diagnosis could not be made preoperatively. We considered carcinoma of the duodenum or of the ampulla of vater or bile duct and GIST in the differential diagnosis. Pancreaticoduodenectomy was performed. The tumor was of stet nodular type, measuring 80×75×34 mm in size. Histopathological examination showed the presence of adenocarcinoma, squamous cell carcinoma and sarcoma components in the same tumor. Immunohistochemical study showed strongly positive staining of the sarcoma component for c-kit. The tumor was diagnosed as true carcinosarcoma, probably arising from the lower part of the bile duct. The sarcoma component was confirmed to be GIST. Although curative resection was performed, the patient died on the 184^th postoperative day because of multiple liver metastases, lung metastases and lymph node metastases. Because true carcinosarcoma of the bile duct is rare, we have reported this case here.

Key words
true carcinosarcoma, bile duct, gastrointestinal stromal tumor

Reprint requests
Tomotaka Yasumura Department of Surgery, Yamanashi Hospital of Social Insurance
3-8-31 Asahi, Kofu, 400-0008 JAPAN

Accepted
June 18, 2008

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