Izumi Hideki, Yazawa Naoki, Furukawa Daisuke, Masuoka Yoshihito, Yamada Misuzu, Mashiko Taro, Kawashima Yohei, Ogawa Masami, Kawaguchi Yoshiaki, Mine Tetsuya, Hirabayashi Kenichi, Nakagohri Toshio
Department of Gastrointestinal Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
Surg Case Rep. 2016 Dec;2(1):102. doi: 10.1186/s40792-016-0233-7. Epub 2016 Sep 27.
Carcinosarcoma of the ampulla of Vater is extremely rare, and to the best of our knowledge, this is the third reported study.
The patient was a 73-year-old man, who presented with a chief complaint of dark urine. After a work-up, we suspected duodenal papillary cancer and performed a subtotal stomach-preserving pancreaticoduodenectomy with lymph node dissection. Immunohistochemically, the sarcomatous atypical cells were diffusely positive for cytokeratin AE1&3 and vimentin and focally positive for α-smooth muscle actin; these cells were also negative for desmin, CD34, DOG1, c-kit, and S100. From these findings, we diagnosed the patient with so-called carcinosarcoma. There was no lymph node metastasis.
Carcinosarcoma of the ampulla of Vater has a poor prognosis, and lymph node metastases are often seen. For the complete cure of carcinosarcoma of the ampulla of Vater, resection with the dissection of the lymph nodes may be necessary.
壶腹癌肉瘤极为罕见，据我们所知，这是第三篇报道的研究。
患者为一名73岁男性，主要症状为尿色加深。经过检查，我们怀疑是十二指肠乳头癌，并进行了保留胃的胰十二指肠次全切除术及淋巴结清扫术。免疫组化显示，肉瘤样非典型细胞细胞角蛋白AE1&3和波形蛋白弥漫性阳性，α平滑肌肌动蛋白局灶性阳性；这些细胞结蛋白、CD34、DOG1、c-kit和S100均为阴性。根据这些结果，我们诊断该患者为所谓的癌肉瘤。无淋巴结转移。
壶腹癌肉瘤预后较差，常出现淋巴结转移。为彻底治愈壶腹癌肉瘤，可能需要进行淋巴结清扫的切除术。
