Gallbladder carcinosarcoma accompanied with bile duct tumor thrombi: A case report

Area of Science:

• Oncology
• Gastroenterology
• Surgical Pathology

Background:

• Gallbladder carcinosarcoma is an extremely rare malignancy, with fewer than 100 cases reported globally.
• This study presents a unique case of gallbladder carcinosarcoma with associated tumor thrombi in the common bile duct.

Purpose of the Study:

• To report a rare case of gallbladder carcinosarcoma with common bile duct tumor thrombi.
• To highlight the diagnostic challenges and surgical management of this rare condition.

Main Methods:

• Surgical resection including cholecystectomy, liver segmentectomy (S4a+S5), and lymph node dissection.
• Intraoperative frozen section analysis to confirm common bile duct tumor thrombus.
• Resection of the extrahepatic bile duct and Roux-en-Y hepatic cholangiojejunostomy.

Main Results:

• A rare case of gallbladder carcinosarcoma with tumor thrombi in the common bile duct was successfully managed.
• The tumor thrombus was confirmed intraoperatively and required extensive surgical intervention.
• The patient showed no evidence of recurrence or metastasis post-surgery.
• The gallbladder carcinosarcoma was noted to produce alpha-fetoprotein.

Conclusions:

• Gallbladder carcinosarcoma with common bile duct tumor thrombi is exceedingly rare and can be misdiagnosed as choledocholithiasis.
• Surgical management is crucial for this rare presentation.
• Prognosis and treatment are comparable to gallbladder carcinoma.