Carcinosarcoma, an atypical subset of gallbladder malignancies.
Carcinosarcoma represents an atypical subset of gallbladder malignancies, and sonographic imaging features have not yet been precisely defined. Previously reported cases have shown a heterogeneously echogenic solid mass protruding into and filling the gallbladder lumen. We present herein a case of carcinosarcoma and propose another finding suggestive of this tumor. The patient was a woman in her 70s. Abdominal sonography revealed that the gallbladder lumen was half-filled by a large mass (maximum diameter, 68 mm) showing heterogeneous echogenicity slightly higher than that of bile. However, despite the large size of the mass, gallbladder shape was well-preserved. Considering the findings on computed tomography, cholecystectomy was performed under a diagnosis of gallbladder malignancy. Pathological examination revealed two types of malignant histology: a sarcomatous element of malignant spindle cells and a carcinomatous element of adenocarcinoma tissue. Foci of malignant cartilage and bone areas were also found sporadically. Accompanied by immunohistochemical examination, the mass was diagnosed as carcinosarcoma. The present case showed somewhat different imaging findings from those of ordinary gallbladder carcinoma. Carcinosarcoma should be considered when a well-preserved shape of the gallbladder is recognized along with protrusion of a large heterogeneously echogenic mass into and filling the gallbladder lumen.
Department of Laboratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan. kishino@ks.kyorin-u.ac.jp.|Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan. kishino@ks.kyorin-u.ac.jp.
Tomonori
T
Kishino
Department of Surgery, Kyorin University School of Medicine and Hospital, Tokyo, Japan.
Toshiyuki
T
Mori
Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan.
Shiho
S
Kawai
The Third Department of Internal Medicine, Kyorin University School of Medicine and Hospital, Tokyo, Japan.
Hideaki
H
Mori
The Third Department of Internal Medicine, Kyorin University School of Medicine and Hospital, Tokyo, Japan.
Kaori
K
Nishikawa
Department of Pathology, Kyorin University School of Medicine and Hospital, Tokyo, Japan.
Kazuhiko
K
Hirano
Department of Laboratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
Satsuki
S
Matsushima
Department of Laboratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.|Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan.
Kouki
K
Ohtsuka
Department of Laboratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.|Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan.
Hiroaki
H
Ohnishi
Department of Laboratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.|Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan.
Takashi
T
Watanabe
D000368:Aged; D002296:Carcinosarcoma / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging* / Q000473:pathology; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
Carcinosarcoma; Gallbladder; Preservation; Shape; Sonography