A Resected Case of Pure Carcinosarcoma of the Gallbladder that Mimicked Acute Hemorrhagic Cholecystitis

Abstract

We report a rare case of carcinosarcoma of the gallbladder that mimicked acute hemorrhagic cholecystitis. An 86-year-old woman was referred to our hospital because of right upper quadrant pain that had presented the day before the referral. Enhanced computed tomography showed enlargement of the gallbladder, thickening of the gallbladder wall, a stone in the fundus, and a linear high-density area in the gallbladder lumen. The lumen showed heterogeneous hyperintensity on T2-weighted magnetic resonance imaging. The patient was diagnosed with acute hemorrhagic cholecystitis and underwent laparoscopic cholecystectomy. Macroscopically, the gallbladder was filled with a solid pedunculated tumor. Histologically, the tumor consisted of adenocarcinoma and sarcomatous tumor cells with cartilaginous tissue. Immunohistochemically, the sarcomatous elements tested negative for cytokeratin AE1/AE3 and positive for desmin and smooth muscle actin. Based on these findings, the patient was diagnosed with pure carcinosarcoma of the gallbladder. Considering her age, additional excision was not performed. She remains alive with no signs of recurrence 8 months after the surgery.