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Granular cell tumors (GCT) are rare benign tumors. Less than 1% of GCTs involve the extrahepatic biliary tree. Most researches favour a Schwann cell origin. Patient, caucasion, female, 31-year-old presented with 4 month history of painless jaundice and pruritus. US and CT revealed dilatation of intrahepatic biliary tree and surgery was performed. Firm tumor mass was found above the conjunction of cystic duct and common hepatic duct (CHD) that caused obstruction and gallblader empyema. The patient underwent radical surgical procedure because Klatskin tumor was clinically suspected. Patohystology and immunohistochemistry confirmed granular cell tumor. Eight years after surgery the patient is wellbeing without symptoms. To our knowledge 69 cases of GCT of the extrahepatic biliary tree have been reported and none of the acute acalculous cholecystitis case acompanied by GCT of CHD. Granular cell tumors are rarely diagnosed preoperatively. Wide resection offers the best chance for cure.

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Carcinosarcomas are rare, malignant, biphasic tumors. We report the case of a 62-year-old man with gastric carcinosarcoma, along with its clinical, macroscopic and histopathological features. Macroscopically, a specimen of deformed stomach was obtained that measured 200 mm x 150 mm x 100 mm. A 150 mm x 100 mm x 50 mm exophytic tumoral mass (Borrmann type I) was found, which involved the posterior wall from the cardia to the antrum. Histopathologically, a mixed type of malignancy was revealed: an adenocarcinoma with intestinal metaplasia, with interposed fascicles of fusiform atypical cells and numerous large, rounded and oval cells. The tumor showed positive histochemistry for cytokeratin 18, epithelial membrane antigen, carcinoembryonic antigen, chromogranin A and vimentin. Liver metastases were diagnosed 8 mo postoperatively, and the patient died 4 mo later. A review of the available literature is also presented.

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