Abstract
A 50-year-old woman consulted a clinician with the complaint of epigastralgia and was diagnosed as cholecystitis. Laboratory findings showed mild liver dysfunction and inflammatory change. US showed the protruded lesion with heterogeneous internal echo texture, in which consistent flow signal was detected by doppler image. EUS delineated both an anomalous arrangement of the pancreaticobiliary ductal system and a swollen lymph node belonging to the bile duct. CT showed the tumor with irregular enhancement in the fundus. MRI showed a rush growth of the tumor during one month and suspected a liver invasion. She underwent an extended cholecystectomy with pancreatododenecomy. A smooth, pedunculated tumor was located in the fundus without any hyperplastic change due to anomalous arrangement of the pancreaticobiliary ductal system. Histologically, the tumor was consisted of sarcomatous component with spindle cells and a small amount of adenocarcinomatous component. As the sarcomatous element was positive only for vimentin and negative for cytokeratin, our case was diagnosed as pure carcinosarcoma of the gallbladder. She died 4 month after the surgery due to the rapidly aggravated hepatic metastases.
