Pu Jeffrey J, Wu Weize
The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medicine, Baltimore, Maryland, USA.
BMJ Case Rep. 2011 Apr 1;2011:bcr0520103009. doi: 10.1136/bcr.05.2010.3009.
Gallbladder carcinosarcoma is a rare gastrointestinal tract malignant tumour, which contains both epithelial cancer component and mesenchymal sarcoma component. Because of its unique anatomic location and unspecific medical presentation, preoperative diagnosis is difficult. The prognosis of gallbladder carcinoma is poor with median survival time of 5.5 months. T- and N-staging system has no role in cancer prognostic stratification. Currently, we still have limited experience in managing this form of notorious cancer. Surgical resection is the common practice in treating gallbladder carcinoma though recurrence rate is high (80%). Here, we report a 59-year-old female with new diagnosed gallbladder carcinosarcoma. She was found to have a carcinosarcoma masse at gallbladder extending into proximal bile ducts with no metastatic lesion. She underwent a radical cholangiocholecystocholedochectomy and Roux-en-Y hepatocholangioduodenostomy. Postsurgery, she received six cycles of adjuvant chemotherapy consisting of oxaliplatin and 5-fluorouracil. She maintains in complete remission 6 months after adjuvant chemotherapy.
胆囊癌肉瘤是一种罕见的胃肠道恶性肿瘤,它同时包含上皮癌成分和间叶肉瘤成分。由于其独特的解剖位置和不具特异性的临床表现,术前诊断较为困难。胆囊癌的预后很差,中位生存时间为5.5个月。T分期和N分期系统在癌症预后分层中并无作用。目前,我们在处理这种恶性程度高的癌症方面经验仍然有限。手术切除是治疗胆囊癌的常用方法,不过复发率很高(80%)。在此,我们报告一名新诊断为胆囊癌肉瘤的59岁女性。她被发现胆囊有一个癌肉瘤肿块,已延伸至近端胆管,且无转移病灶。她接受了根治性胆管胆囊胆总管切除术和Roux-en-Y肝管十二指肠吻合术。术后,她接受了六个周期由奥沙利铂和5-氟尿嘧啶组成的辅助化疗。辅助化疗6个月后,她保持完全缓解状态。