Department of Gastroenterological Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Tokai J Exp Clin Med. 2022 Sep 20;47(3):149-153.
Carcinosarcoma of the gallbladder (CSGB) is very rare, accounting for less than 1% of gallbladder malignancies. Therefore, the biological behavior is not well known. We report the case of a patient with CSGB who showed long-term survival after treatment with surgery and postoperative adjuvant chemotherapy.
A 79-year-old man was referred to our department with suspected gallbladder cancer after undergoing positron emission tomography-computed tomography (PET-CT) scan for preoperative examination of lung cancer, which showed strong accumulation in the gallbladder. Abdominal contrast-enhanced computed tomography (CT) demonstrated a heterogeneous enhanced, 25-mm mass in the anterior wall of the gallbladder fundus. Cholecystectomy and hepatoduodenal mesenteric lymph node sampling revealed a polypoid tumor. Histopathological findings showed a mixture of adenocarcinoma and sarcoma with spindle-shaped cells. Immunohistochemical s taining of the s arcoma s howed negative results for the epithelial markers and positive results for the mesenchymal markers, leading to a diagnosis of true CSGB. We administered S-1 as postoperative adjuvant chemotherapy and was reported to be alive 45 months after surgery without recurrence.
CSGB has a poor prognosis, but if radical resection can be performed, there is a possibility of long-term survival. Further case studies and treatment options are needed to help understand this disease.
胆囊癌肉瘤（CSGB）非常罕见，占胆囊恶性肿瘤的比例不到 1%。因此，其生物学行为尚不清楚。我们报告了一例 CSGB 患者，该患者在接受手术和术后辅助化疗治疗后表现出长期生存。
一名 79 岁男性因肺癌术前检查行正电子发射断层扫描-计算机断层扫描（PET-CT）检查后被转至我科，疑诊为胆囊癌，提示胆囊强烈积聚。腹部增强 CT 显示胆囊底部前壁有一个不均匀强化的 25mm 肿块。胆囊切除术和肝十二指肠系膜淋巴结采样显示息肉样肿瘤。组织病理学检查显示腺癌和梭形细胞肉瘤的混合物。肉瘤的免疫组织化学染色显示上皮标志物阴性，间充质标志物阳性，诊断为真正的 CSGB。我们给予 S-1 作为术后辅助化疗，术后 45 个月报告无复发，患者存活。
CSGB 预后不良，但如果能进行根治性切除，有可能长期生存。需要进一步的病例研究和治疗选择来帮助了解这种疾病。
