A case of resected carcinosarcoma of the bile duct with long-term survival

Abstract

A 69-year-old man with jaundice was referred to our hospital. Computed tomography and magnetic resonance imaging showed thickened and enhanced bile duct wall in the distal bile duct. Brush cytology in the distal bile duct showed class III, and surgery was performed because of suspected cholangiocarcinoma. Subtotal stomach-preserving pancreaticoduodenectomy plus partial transverse colon resection was performed. The resected specimen revealed a 6 cm × 3 cm tumor that almost extended in the bile duct, from the papilla of Vater to the hepatic-side resected margin. Hematoxylin and eosin staining revealed that the tumor consisted of carcinosarcoma, adenocarcinoma, and squamous cell carcinoma components. Immunohistochemical staining was positive for AE1/AE3, vimentin, and HHF35; therefore, this case was diagnosed as bile duct carcinosarcoma. The patient took S-1 orally after surgery, and he is alive, with no recurrence for 42 months. We report a rare case of a patient with bile duct carcinosarcoma with long-term survival.