胆管肉瘤样癌：一例报告。
Sarcomatoid carcinoma of the common bile duct: A case report.
作者信息
Zhang Shuisheng, Jia Jia, Bi Xiaoning, Jiang Qinglong, Zhao Yajie, Chen Yingtai, Xu Quan, Lan Zhongmin, Zhang Jianwei, Zhang Zhihui, Wang Chengfeng
机构信息
Department of Abdominal Surgical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
出版信息
Medicine (Baltimore). 2017 Jan;96(3):e5751. doi: 10.1097/MD.0000000000005751.
RATIONALE
Sarcomatoid carcinoma is an extremely rare lesion in the common bile duct (CBD).
PATIENT CONCERNS
We present a case of sarcomatoid carcinoma of the distal CBD in a 51-year-old woman who presented with jaundice and abdominal pain. Whipple's operation was performed successfully. Microscopically, the tumor was a poorly differentiated carcinoma containing a component of sarcoma-like differentiation. The tumor cells displayed spindle-shaped nuclei with occasional mitotic figures. Cytokeratin (CK) 7, CK19, CK18, and pan-CK (AE1/AE3) staining was positive on immunohistochemistry. Vimentin and carcinoembryonic antigen (CEA) staining were also positive.
DIAGNOSES
Sarcomatoid carcinoma of the distal CBD.
INTERVENTIONS
The patient received three cycles of chemotherapy after surgery.
OUTCOMES
The patient has experienced no adverse events in the 3 years post-surgery.
LESSONS
We present here a case report of sarcomatoid carcinoma of the distal CBD. The patient received chemotherapy after surgery, and was event-free for 3 years post-surgery, suggesting a relatively better prognosis, despite the infiltrative pattern of the tumor.
理论依据
肉瘤样癌在胆总管中是一种极其罕见的病变。
患者情况
我们报告一例51岁女性远端胆总管肉瘤样癌病例，该患者表现为黄疸和腹痛。成功实施了惠普尔手术。显微镜下，肿瘤为低分化癌，含有肉瘤样分化成分。肿瘤细胞呈梭形核，偶见有丝分裂象。免疫组化显示细胞角蛋白（CK）7、CK19、CK18和泛CK（AE1/AE3）染色呈阳性。波形蛋白和癌胚抗原（CEA）染色也呈阳性。
诊断
远端胆总管肉瘤样癌。
干预措施
患者术后接受了三个周期的化疗。
结果
患者术后3年未出现不良事件。
经验教训
我们在此报告一例远端胆总管肉瘤样癌病例。患者术后接受了化疗，术后3年无事件发生，提示尽管肿瘤呈浸润性生长模式，但预后相对较好。
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