Carcinosarcoma of the ampulla of Vater: a case report and literature review
Tóm tắt
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.
Tài liệu tham khảo
Wick MR, Swanson PE. Carcinosarcomas: current perspectives and an historical review of nosological concepts. Semin Diagn Pathol. 1993;10:118–27.
Anupama R, Kuriakose S, Vijaykumar DK, Pavithran K, Jojo A, Indu RN, Sheejamol VS. Carcinosarcoma of the uterus-a single institution retrospective analysis of the management and outcome and a brief review of literature. Indian J Surg Oncol. 2013;4:222–8.
Zehani A, Ayadi-Kaddour A, Marghli A, Maamouri H, Kassar L, Kilani T, El Mezni F. Sarcomatoid carcinoma of the lung: retrospective study of 28 cases. Ann Pathol. 2014;34:124–9.
Okabayashi T, Shima Y, Iwata J, Iiyama T, Sumiyoshi T, Kozuki A, Tokumaru T, Hata Y, Noda Y, Morita M. Surgical outcomes for 131 cases of carcinosarcoma of the hepatobiliary tract. J Gastroenterol. 2014;49:982–91.
Zhou C, Xie LP, Zheng XY. Sarcomatoid carcinoma of the urinary tract: clinical analysis of 16 cases. Zhonghua Zhong Liu Za Zhi [Chinese journal of oncology]. 2011;33:634–5.
Kench JG, Frommer DJ. Sarcomatoid carcinoma of the ampulla of Vater. Pathology. 1997;29:89–91.
Kijima H, Takeshita T, Suzuki H, Tanahashi T, Suto A, Izumika H, Miki H, Terasaki Y, Nakamura M, Watanabe H, Tamaoki N, Omiya H. Carcinosarcoma of the ampulla of Vater: a case report with immunohistochemical and ultrastructural studies. American J Gastroenterol. 1999;94:3055–9.
Sunagawa H, Inamine S, Watanabe M, Kawakami K, Toyama T, Zaha H, Yonaha T, Ohta M, Oshiro N, Takeshima M, Uchima H. Carcinosarcoma of the duodenum: report of a case. Surg Today. 2009;39:892–6.
Gao S, Huang L, Dai S, Chen D, Dai R, Shan Y. Carcinosarcoma of the gallbladder: a case report and review of the literature. Int J Clin Exp Pathol. 2015;8:7464–9.
Wang Y, Gu X, Li Z, Xiang J, Chen Z. Gallbladder carcinosarcoma accompanied with bile duct tumor thrombi: a case report. Oncol Lett. 2013;5:1809–12.
Chino O, Kijima H, Shimada H, Nishi T, Tanaka H, Oshiba G, Kise Y, Kenmochi T, Himeno H, Tsuchida T, Kawai K, Tanaka M, Machimura T, Tajima T, Makuuchi H. Clinicopathological studies of esophageal carcinosarcoma: analyses of its morphological characteristics using endoscopic, histological, and immunohistochemical procedures. Endoscopy. 2000;32:706–11.
Gu L, Xu Y, Chen Z, Pan Y, Lu S. Clinical analysis of 95 cases of pulmonary sarcomatoid carcinoma. Biomed Pharmacother. 2015;76:134–40.
Lu J, Zhang J, Xiong XZ, Li FY, Ye H, Cheng Y, Zhou RX, Lin YX, Cheng NS. Primary hepatic sarcomatoid carcinoma: clinical features and prognosis of 28 resected cases. J Cancer Res Clin Oncol. 2014;140:1027–35.
Okabayashi T, Sun ZL, Montgomey RA, Hanazaki K. Surgical outcome of carcinosarcoma of the gall bladder: a review. World J Gastroenterol. 2009;15:4877–82.
Cavallin F, Scarpa M, Alfieri R, Cagol M, Ruol A, Rugge M, Ancona E, Castoro C. Esophageal carcinosarcoma: management and prognosis at a single Italian series. Anticancer Res. 2014;34:7455–9.
Sodergren MH, Silva MA, Read-Jones SL, Hubscher SG, Mirza DF. Carcinosarcoma of the biliary tract: two case reports and a review of the literature. Eur J Gastroenterol Hepatol. 2005;17:683–5.
Makris GM, Siristatidis C, Battista MJ, Chrelias C. Ovarian carcinosarcoma: a case report, diagnosis, treatment and literature review. Hippokratia. 2015;19(3):256–9.
Virchow R. Die Krankhaften Geschwulste. In: A Hirschwald, editor. Berlin; 1864. p. 181–182
Humphrey PA, Scroggs MW, Roggli VL, Shelburne JD. Pulmonary carcinomas with a sarcomatoid element: an immunocytochemical and ultrastructural analysis. Hum Pathol. 1988;19:155–65.