2018 Volume 32 Issue 5 Pages 918-925
So-called carcinosarcoma is rare as a carcinoma of extrahepatic bile duct. Herein, we reported a case of sarcomatoid carcinoma with a specific appearance of peroral cholangioscopy (POCS). 66-year-old man was admitted to our hospital with obstructive jaundice. Laboratory findings demonstrated mild hyperbilirubinemia and liver dysfunction. CT imaging showed that the tumor was slightly enhanced in the distal common bile duct just above a major papilla. POCS disclosed that the tumor had a subpedunculated shape and elevated steeply on the villous mucosa just at the site on the CT imaging. Biopsy confirmed that histology of the tumor was a poorly differented cholanagioadenocarcinoma. Pancreatoduodenectomy was performed successfully. On microscopic examination after surgery, the tumor was poorly differented adenocarcinoma containing a component of sarcoma-like differentiation. Both of carcinoma component and sarcomatoid component were positive for Vimentin and CAM5.2. Final diagnosis was a sarcomatoid carcinoma.
