Katsube Tomoya, Watanabe Yoshihisa, Hannoda Rie, Umeda Shugo, Wada Rikimon, Takahashi Makoto, Kobayashi Yasutsugu, Arakawa Tetsuo
Department of Internal Medicine, Asakayama General Hospital, Japan.
Nihon Shokakibyo Gakkai Zasshi. 2012 Feb;109(2):217-23.
A 98-year-old woman with aspiration pneumonia caused by vomiting was admitted to our hospital. Abdominal computed tomography and ultrasonography showed common bile duct dilation and occlusion of the gastrointestinal tract due to a large tumor in the duodenum. Aspiration pneumonia and hepatic failure led to the patient's death. Pathological autopsy showed an 11 × 6 × 2.5-cm polypoid tumor originating from the descending part of the duodenum and involving the common bile duct. Histological examination of the tumor showed mainly spindle cells but also some adenocarcinoma cells. Tumor cells, including spindle cells, were strongly positive for cytokeratin 7; therefore, sarcomatoid carcinoma originating from the duodenum was diagnosed. To the best of our knowledge, only 5 cases of sarcomatoid carcinoma originating from the duodenum have been reported, and they often show polypoid growth. The possibility of sarcomatoid carcinoma should be considered if such findings are noted.
一名98岁因呕吐导致吸入性肺炎的女性被收治入院。腹部计算机断层扫描和超声检查显示，十二指肠内有一个大肿瘤，导致胆总管扩张和胃肠道梗阻。吸入性肺炎和肝衰竭导致患者死亡。病理尸检显示，一个11×6×2.5厘米的息肉样肿瘤起源于十二指肠降部并累及胆总管。肿瘤组织学检查显示主要为梭形细胞，但也有一些腺癌细胞。包括梭形细胞在内的肿瘤细胞细胞角蛋白7呈强阳性；因此，诊断为起源于十二指肠的肉瘤样癌。据我们所知，仅报道过5例起源于十二指肠的肉瘤样癌病例，且它们常呈息肉样生长。如果发现此类表现，应考虑肉瘤样癌的可能性。
