Experience of the pancreas duodenectomy for so-called carcinosarcoma of the common bile duct:a case report and review of literature

Sasamoto, Suguru; Aoki, Takeshi; Tashiro, Yoshihiko; Matsuda, Kazuhiro; Koizumi, Toru; Kusano, Tomokazu; Wada, Yusuke; Shibata, Hideki; Tomioka, Katsuhiro; Yamashita, Takeshi; Date, Hiromi; Ariyoshi, Tomotake; Goto, Satoru; Yamazaki, Kaoru; Fujimori, A.; Watanabe, Makoto; Enami, Yuta; Otsuka, Koji; Norose, Tomoko; Ohike, Nobuyuki; Yamochi, Toshiko; Takimoto, Masafumi; Murakami, Masahiko

doi:10.1007/s13691-020-00462-y

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…Through literature review, we found only 12 case reports (Table 1 ). Through these 12 cases[ 1 , 5 , 9 - 18 ], we found that the prevalence is consistent between male and female. Among them, 9 patients were more than 70 years old.…”

Section: Discussionmentioning

confidence: 86%

“…According to the 2006 WHO classification of tumors[ 3 ], carcinosarcoma is classified as a subset of sarcomatoid carcinoma and defined as a mixed tumor with cancer and differentiated sarcomatous components ( e.g., malignant cartilage, bone, or rhabdomyosarcoma). The mechanism of its development is currently discussed in several ways: (1) Collision theory: Two independent malignancies colliding; (2) Combination theory: The tumor is thought to have a dual origin[ 4 ], wherein the cancer is derived from epithelial cells and the sarcoma from mesenchymal tissue, and that the stem cells develop into both cancer and sarcoma and infiltrate each other at the same location in the same organ to form a carcinosarcoma; (3) Conversion theory: The sarcomatous part is derived from the carcinomatous part via metaplastic transformation; and (4) Composition theory: The carcinoma drives a pseudosarcomatous stromal reaction[ 5 ]. The current study proposes an alternative hypothesis[ 6 ]: That carcinosarcomas are monoclonal tumors with heterologous differentiation, in which cancer and sarcoma components are derived from a subpopulation of epithelial stem cells that de-differentiate and express mesenchymal markers.…”

Section: Discussionmentioning

confidence: 99%

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Carcinosarcoma of common bile duct: A case report

Yao¹,

Xiang²,

Liu³

et al. 2023

World J Gastrointest Oncol

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BACKGROUND Carcinosarcomas of the common bile duct (CBD) are an extremely rare finding in the clinical setting. Based on a review of 12 literatures, 3 cases had the imaging features of ossification. Carcinosarcomas are prone to distant metastasis, as they possess clinical features of both carcinoma and sarcoma, and generally have with a poor prognosis. Due to the small number of cases reported, clinical experience in the diagnosis and treatment of the disease is lacking. CASE SUMMARY The patient was a 75-year-old woman who had experienced recurrent chills with nausea and vomiting for 3 mo. Computed tomography, magnetic resonance imaging, endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography led to the diagnosis of malignant tumor of the CBD. The patient ultimately underwent cholecystectomy, CBD resection, and choledochojejunostomy. Postoperative pathological examination revealed carcinosarcoma of the CBD, and the latest follow-up showed that the patient is recovering well. Based on previous case reports, some carcinosarcoma has ossification characteristics in imaging. If it is misdiagnosed as biliary calculi, the use of laser lithotripsy in surgery may lead to tumor diffusion. Choledochoscopy and narrow band staining of mucosa are very important for diagnosis. CONCLUSION We herein present a rare case of carcinosarcomas of the CBD, we found the tumours may have imaging features of polypoid growth and ossification only when the sarcomal components are bone differentiation, while show soft tissue shadow when non bone differentiation. Confirmation of diagnosis depends greatly upon postoperative pathological examination and the adjuvant treatment has not been established, which leads to the poor prognosis.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Carcinosarcoma of common bile duct: A case report

Yao¹,

Xiang²,

Liu³

et al. 2023

World J Gastrointest Oncol

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“…In the distal bile duct, 10 resected cases with undifferentiated features have been reported (Table 2) [7,9,10,[18][19][20][21][22][23][24]. Most tumors were sarcomatoid-type carcinoma, and there was no anaplastic-type carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Aggressive behavior of anaplastic undifferentiated carcinoma arising from the hilar bile duct

et al. 2022

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Background Undifferentiated carcinoma of the biliary tree is extremely rare, and biliary undifferentiated carcinoma mostly originates from the gallbladder. We herein present a case of anaplastic undifferentiated carcinoma of the hilar bile duct and reviewed the literature. Case presentation The patient was an 81-year-old male with obstructive jaundice. Contrast-enhanced computed tomography (CT) showed a protruded tumor located at the hepatic hilum. Obstructive jaundice was relieved by endoscopic drainage. Endoscopic biopsy revealed carcinoma without glandular differentiation, and the patient was diagnosed with resectable hilar undifferentiated carcinoma. During the 5-week preoperative examination, the tumor increased in size from 23 to 45 mm. Left hemi-hepatectomy and extrahepatic bile duct resection were performed, and there were no postoperative complications. Histological findings demonstrated that the tumor was mainly composed of non-cohesive polygonal neoplasms with pleomorphic nuclei, and was diagnosed as anaplastic undifferentiated carcinoma of the common hepatic duct (T2a N0 M0 Stage II). One month after surgery, the patient was readmitted to our hospital with pyrexia due to cholangitis, and liver nodules suggestive of multiple liver metastases were detected by CT. Three months after surgery, the patient died of multiple liver metastases. Conclusions This is the first case report of undifferentiated cholangiocarcinoma with anaplastic features. Anaplastic undifferentiated carcinoma of the hilar bile duct showed preoperative rapid growth and early relapse despite a cancer-negative surgical margin.

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“…Carcinosarcoma (CS) is a rare but exceedingly aggressive tumour characterised by high metastasis rates and poor prognosis. Since Virchow et al first reported it in 1863, a growing number of researchers have described it in the genitourinary tract, digestive tract, breast, lung and other sites of the body 1. The incidence of CS and correlated cancers is highly variable and relies on the anatomical sites, ranging from extremely infrequent in the skin to as much as approximately 5%–10% of grades III–IV uterine corpus tumours 2.…”

Section: Introductionmentioning

confidence: 99%

“…Since Virchow et al first reported it in 1863, a growing number of researchers have described it in the genitourinary tract, digestive tract, breast, lung and other sites of the body. 1 The incidence of CS and correlated cancers is highly variable and relies on the anatomical sites, ranging from extremely infrequent in the skin to as much as approximately 5%–10% of grades III–IV uterine corpus tumours. 2 In the uterus and adnexa, CS is grouped as (malignant) mixed Müllerian tumours (MMMTs).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology, site-specific characteristics and survival of carcinosarcoma: a retrospective study based on SEER database

Tang,

Zhou,

Wang

et al. 2023

BMJ Open

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ObjectivesCarcinosarcoma (CS) is a rare and biphasic malignancy characterised by a highly invasive biological nature and poor prognosis. This study explored the epidemiology, site-specific characteristics and survival outcome of CS.DesignWe conducted a retrospective study in the Surveillance, Epidemiology and End Results (SEER) database (1975–2018) for primary CS.Setting and participantsSEER database includes publicly available information from regional and state cancer registries in the US centres. A total of 5042 CS patients were identified. We selected the top five anatomic CS (uterus, double adnexa, lung, bladder and breast) patients for further analysis.Primary outcome measuresIncidence was estimated by geographical region, age, sex, race, stage and primary site. Trends were calculated using joinpoint regression. The cancer-specific survival (CSS) rate and initial treatment were summarised.ResultsNearly 80% of CS occurred in the uterus and double adnexa, followed by lung, bladder and breast. The elderly and black population presented the highest age-adjusted rate of CS. The rates of distant metastasis in CS progressively increased from 1989 to 2018. Atlanta was the area with the highest incidence at 0.7 per 100 000. Pulmonary and bladder CS more frequently occurred in men and were diagnosed with regional stage. Distant metastasis was mostly found in ovary/fallopian tube CS. Radiotherapy was more commonly applied in uterine CS, while adnexa CS cases were more likely to receive chemotherapy. Multiple treatments were more used in breast CS. Pulmonary CS seemed to suffer worse CSS (median: 9.92 months), for which radiotherapy might not provide survival benefits (HR 0.60, 95% CI 0.42 to 0.86). Compared with the common histological types in each site, CS had the shortest survival.ConclusionsCS has unique clinical features in each primary site. Substantial prognosis variances exist based on tumour locations. The aggressive course is the common feature in CS at all sites.

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Experience of the pancreas duodenectomy for so-called carcinosarcoma of the common bile duct:a case report and review of literature

Cited by 4 publications

References 18 publications

Carcinosarcoma of common bile duct: A case report

Carcinosarcoma of common bile duct: A case report

Aggressive behavior of anaplastic undifferentiated carcinoma arising from the hilar bile duct

Epidemiology, site-specific characteristics and survival of carcinosarcoma: a retrospective study based on SEER database

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