Tanaka Hiroki, Baba Youichirou, Matsusaki Shimpei, Isono Yoshiaki, Kumazawa Hiroaki, Sase Tomohiro, Okano Hiroshi, Saito Tomonori, Mukai Katsumi, Taoka Hiroki
Department of Gastroenterology, Suzuka General Hospital, 1275-53, Yamanohana, Yasuzuka, Suzuka-shi, Mie, Japan.
Department of Pathology, Suzuka General Hospital, 1275-53, Yamanohana, Yasuzuka, Suzuka-shi, Mie, Japan.
Clin J Gastroenterol. 2015 Oct;8(5):268-74. doi: 10.1007/s12328-015-0595-6. Epub 2015 Aug 7.
Carcinosarcoma is a biphasic malignant tumor consisting of both carcinomatous and sarcomatous components, and its occurrence in the duodenum is very rare. In the present report, we describe a case of so-called carcinosarcoma of the duodenum with a chondrosarcomatous component. A 79-year-old man was referred to our hospital because of anorexia, weight loss, and jaundice. A preoperative imaging examination showed a hypovascular mass located in the pancreatic head. Histological examination of specimens obtained through a forceps biopsy revealed anaplastic carcinoma (spindle cell type), and a pancreatoduodenectomy was performed. Histologically, the tumor showed an elevated lesion with a wide base in proximity to duodenal mucosal carcinoma. The tumor was found to be predominantly composed of sarcoma with carcinomatous and chondrosarcomatous components. There was a transitional zone between the carcinomatous and sarcomatous components, and a portion of the sarcomatous component was positive for cytokeratin, and negative for vimentin. As mentioned above, we diagnosed the lesion as so-called carcinosarcoma with a chondrosarcomatous component.
癌肉瘤是一种由癌性和肉瘤性成分组成的双相恶性肿瘤,其在十二指肠的发生非常罕见。在本报告中,我们描述了一例具有软骨肉瘤成分的十二指肠所谓癌肉瘤病例。一名79岁男性因厌食、体重减轻和黄疸被转诊至我院。术前影像学检查显示胰头部有一个低血运肿块。经钳取活检获得的标本组织学检查显示为间变性癌(梭形细胞型),遂行胰十二指肠切除术。组织学上,肿瘤表现为十二指肠黏膜癌附近一个基底较宽的隆起性病变。肿瘤主要由肉瘤组成,伴有癌性和软骨肉瘤性成分。癌性和肉瘤性成分之间有一个过渡区,部分肉瘤性成分细胞角蛋白阳性,波形蛋白阴性。如上所述,我们将该病变诊断为具有软骨肉瘤成分的所谓癌肉瘤。