Zhang Ning, Li Yatong, Zhao Mengyun, Chang Xiaoyan, Qu Qiang, He Xiaodong
Department of General Surgery.
Department of Pathology, Peking Union Medical College Hospital, Beijing, China.
Medicine (Baltimore). 2019 Feb;98(8):e14585. doi: 10.1097/MD.0000000000014585.
Sarcomatous carcinoma in biliary system, including sarcomatous intrahepatic cholangiocarcinoma (SIC) and sarcomatous choledochal carcinoma (SCC), is extremely rare and malignant.This retrospective study included 5 patients with SIC and 4 patients with SCC. Their basic characteristics, preoperative lab tests, preoperative imaging features, perioperative status, and follow-up information have been collected and analyzed.Lesions at different locations induced various preoperative symptoms. The history of choledocholithiasis or hepatolithiasis was remarkable in patients with SIC. Cancer antigen 19-9 appeared to be a key factor for both SIC and SCC. However, preoperative lab tests or imaging features could not distinguish SIC from intrahepatic cholangiocarcinoma, or SCC from choledochal carcinoma. Surgical treatments for all 9 patients were successful. Efficacy of adjuvant chemotherapy was not ideal. The prognosis of sarcomatous biliary carcinoma was enormously poor.Sarcomatous carcinoma in biliary system is extremely rare and malignant. Chronic inflammation could be critical in the currently unknown occurrence mechanism. Further research is urgently needed to improve the prognosis.
胆道系统的肉瘤样癌,包括肉瘤样肝内胆管癌(SIC)和肉瘤样胆总管癌(SCC),极为罕见且具有恶性。这项回顾性研究纳入了5例SIC患者和4例SCC患者。收集并分析了他们的基本特征、术前实验室检查、术前影像学特征、围手术期情况及随访信息。不同部位的病变引发了各种术前症状。SIC患者中胆总管结石或肝内结石病史较为显著。癌抗原19-9似乎是SIC和SCC的关键因素。然而,术前实验室检查或影像学特征无法将SIC与肝内胆管癌区分开来,也无法将SCC与胆总管癌区分开来。所有9例患者的手术治疗均成功。辅助化疗效果不理想。肉瘤样胆管癌的预后极差。胆道系统的肉瘤样癌极为罕见且具有恶性。慢性炎症在目前未知的发病机制中可能起关键作用。迫切需要进一步研究以改善预后。