Abstract
A 64-year-old man was admitted to the hospital because of jaundice. Laboratory findings showed T-Bil had increased to 10.2 mg/dl and CA19-9 level was 62 U/ml. Abdominal CT identified an enhanced tumor at the middle to lower extrahepatic bile duct, MRCP showed disruption of the middle bile duct, and ERC revealed the tumor located at the middle and lower bile duct. Positron emission tomography showed 2-［18F］-fluoro-2-deoxy-D-glucose uptake localized to the bile duct. Biopsy specimens taken from the tumor suggested a carcinoma. The patient underwent pylorus-preserving pancreaticoduodenectomy. Histopathology showed that the tumor consisted of intermixed, adenocarcinoma and sarcomatoid spindle cells-so-called carcinosarcoma (undifferentiated carcinoma according to World Health Organization classification) . The tumor was Bmi, fm, pGinf0, pPanc0, pDuo0, int, INF-β, ly0, v0, pn1a, pHM2, pEM0, fStageI.
Carcinosarcoma of the bile duct tends to show a polypoid lesion, and biopsy of the tumor is necessary to differentiate from adenoma, papilloma, inflammatory polyp, calculus and carcinoma.
