Siddiqui Mehdi, Hegde Sheetal, Nguyen Tung, DePaul Scott
Division of General and Hospital Medicine, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
SAGE Open Med Case Rep. 2020 Feb 7;8:2050313X20906739. doi: 10.1177/2050313X20906739. eCollection 2020.
Sarcomatoid carcinoma of the gallbladder or gallbladder carcinosarcoma is an exceedingly rare malignancy. Unfortunately, patients typically present with advanced disease at diagnosis. Symptoms may include abdominal pain, jaundice, anorexia, nausea, weight loss, and a palpable abdominal mass. This malignant tumor has a poor prognosis, and treatment options include surgical resection, radiation, and chemotherapy. We detail the case of a 57-year-old male who presented with diffuse abdominal pain and jaundice. Computed tomography scan of the abdomen and pelvis showed a large mass within the gallbladder, intrahepatic ductal dilation, gastrohepatic lymph node enlargement, and liver lesions concerning for metastatic disease. A core needle biopsy from one of the liver lesions revealed poorly differentiated sarcomatoid carcinoma of the gallbladder. He was assessed to have stage IV disease and deemed not to be a surgical candidate. Palliative chemotherapy was planned; however, treatment was never started due to the development of cholangitis with sepsis. The patient ultimately opted for hospice care and passed away shortly thereafter.
胆囊肉瘤样癌或胆囊癌肉瘤是一种极其罕见的恶性肿瘤。不幸的是,患者在诊断时通常已处于疾病晚期。症状可能包括腹痛、黄疸、厌食、恶心、体重减轻以及可触及的腹部肿块。这种恶性肿瘤预后较差,治疗选择包括手术切除、放疗和化疗。我们详细介绍了一名57岁男性的病例,该患者出现弥漫性腹痛和黄疸。腹部和骨盆的计算机断层扫描显示胆囊内有一个大肿块、肝内胆管扩张、胃肝淋巴结肿大以及肝脏病变,怀疑有转移性疾病。对其中一个肝脏病变进行的粗针活检显示为低分化胆囊肉瘤样癌。他被评估为IV期疾病,被认为不适合手术。计划进行姑息化疗;然而,由于并发胆管炎伴败血症,治疗从未开始。患者最终选择了临终关怀,此后不久去世。