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Ampullary Carcinosarcoma with Enteroblastic Differentiation: A Case Report.

Muhammad Adnan Haider1,2, Shagufta Naqvi2, Omar Barakat3

  • 1Department of Internal Medicine, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan, "Observer" Premier Oncology Consultants, Houston, TX, USA.

Annals of Clinical and Laboratory Science
|March 3, 2021
PubMed
Summary
This summary is machine-generated.

This report details a rare ampullary carcinosarcoma with enteroblastic differentiation, a unique tumor type. The patient achieved disease-free status after Folfirinox chemotherapy, showing promising outcomes for this aggressive cancer.

Keywords:
ampullacarcinosarcomaenteroblastic differentiationhepatoid differentiationpapilla of Vater

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Area of Science:

  • Gastroenterology and Oncology
  • Pathology
  • Surgical Oncology

Background:

  • Adenocarcinoma with enteroblastic differentiation is a rare malignancy with challenging diagnosis and poor prognosis.
  • While typically found in the stomach, it has been infrequently reported in the esophagus, colon, rectum, and ampulla.
  • Underrecognition by pathologists may contribute to underreporting of this tumor type.

Observation:

  • A unique case of a 59-year-old female with ampullary carcinosarcoma exhibiting enteroblastic differentiation is presented.
  • The diagnosis was made from a pancreatoduodenectomy specimen.
  • The carcinomatous component displayed a tubular architecture with clear cytoplasm and a solid component with trabecular architecture.

Findings:

  • Immunohistochemical analysis revealed expression of SALL4 and AFP (alpha-fetoprotein) in the tumor cells.
  • This represents the first reported instance of carcinosarcoma combined with enteroblastic differentiation.
  • The patient received adjuvant Folfirinox chemotherapy following surgical resection.

Implications:

  • This case highlights the importance of recognizing rare tumor subtypes and their distinct pathological features.
  • The successful treatment with Folfirinox suggests a potential therapeutic option for this rare condition.
  • Further research into enteroblastic differentiation and carcinosarcomas is warranted to improve diagnostic accuracy and patient outcomes.