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Undifferentiated carcinoma of the common bile duct with intraductal tumor thrombi: Report of a case

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Abstract

We report a case of undifferentiated carcinoma of the common bile duct with intraductal tumor thrombi. A 73-year-old man presented with general malaise. Abdominal computed tomography and magnetic resonance imaging revealed a mass in the distal common bile duct, accompanied by dilatation of the intra- and extrahepatic bile ducts. The patient underwent pancreaticoduodenectomy with regional lymphadenectomy. Gross examination revealed that the distal common bile duct was obstructed by an elastic hard mass, 3.2 × 2.6 cm, accompanied by intraductal tumor thrombi. Microscopically, the nodule was well defined and composed of atypical large tumor cells with bizarre nuclei and little cytoplasm. Immunohistochemically, the tumor cells were diffusely positive for cytokeratin-7 and CAM5.2, but negative for CD56, chromogranin A, and synaptophysin. Thus, a histological diagnosis of undifferentiated carcinoma of the common bile duct was made. The patient recovered uneventfully and has remained free of any signs of recurrence for 18 months since the operation. Undifferentiated carcinomas of the extrahepatic bile duct can be detected early, with the chance of a good prognosis; however, because their biologic growth behavior is still considered aggressive, careful observation after surgery and the initiation of multidisciplinary treatment against recurrence are necessary.

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References

  1. Matsui K, Kitagawa M, Miwa A. Lung carcinoma with spindle cell components: sixteen cases examined by immunohistochemistry. Hum Pathol 1992;23:1289–1297.

    Article  PubMed  CAS  Google Scholar 

  2. Zarbo RJ, Crissman JD, Venkat H, Weiss MA. Spindle-cell carcinoma of the upper aerodigestive tract mucosa. An immunohistologic and ultrastructural study of 18 biphasic tumors and comparison with seven monophasic spindle-cell tumors. Am J Surg Pathol 1986;10:741–753.

    Article  PubMed  CAS  Google Scholar 

  3. Evans HL, Smith JL. Spindle cell squamous carcinomas and sarcoma-like tumors of the skin: a comparative study of 38 cases. Cancer 1980;45:2687–2697.

    Article  PubMed  CAS  Google Scholar 

  4. Steeper TA, Piscioli F, Rosai J. Squamous cell carcinoma with sarcoma-like stroma of the female genital tract. Clinicopathologic study of four cases. Cancer 1983;52:890–898.

    Article  PubMed  CAS  Google Scholar 

  5. Gersell DJ, Katzenstein AL. Spindle cell carcinoma of the breast. A clinocopathologic and ultrastructural study. Hum Pathol 1981;12:550–561.

    Article  PubMed  CAS  Google Scholar 

  6. Sumikawa M, Ogawa H, Kaibara H, Adachi H. A case of pseudosarcoma of the bile duct (in Japanese). Geka 1990;52:177–179.

    Google Scholar 

  7. Haratake J, Yamada H, Horie A, Inokuma T. Giant cell tumor-like cholangiocarcinoma associated with systemic cholelithiasis. Cancer 1992;69:2444–2448.

    Article  PubMed  CAS  Google Scholar 

  8. Kagami A, Nikaidou T, Miyairi M, Usui T, Kawashima O, Mochizuki S, et al. An autopsy case of pseudosarcoma of the common bile duct. J Gastroenterol 1994;29:525–530.

    Article  PubMed  CAS  Google Scholar 

  9. Nonomura A, Mizukami Y, Matsubara F, Ueda H. A case of choledochal cyst associated with adenocarcinoma exhibiting sarcomatous features. J Gastroenterol 1994;29:669–675.

    Article  PubMed  CAS  Google Scholar 

  10. Yuan CY, Lo HW, Tseng CH, Takasaki T, Hanyu F. A case of spindle cell sarcomatous change of hepatic ducts manifesting as obstructive jaundice. J Gastroenterol 1995;30:264–267.

    Article  PubMed  CAS  Google Scholar 

  11. Kobayashi T, Kimura T, Yoshida M, Sakuramachi S, Wada H, Suzuki K, et al. A case of so-called carcinosarcoma of the lower bile duct (in Japanese). Biliary System and Pancreas (Tan To Sui) 1997;18:95–99.

    Google Scholar 

  12. Mokuno Y, Katoh T, Yoshida K, Abe T, Maeda M, Chigira H. Undifferentiated spindle cell carcinoma of the extrahepatic bile ducts: a case report. Hepatogastroenterology 2000;47:1234–1237.

    PubMed  CAS  Google Scholar 

  13. Nagai E, Shinohara M, Yonemasu H, Kishikawa H, Tsuneyoshi M. Undifferentiated carcinoma of the common bile duct: case report and review of the literature. J Hepatobiliary Pancreat Surg 2002;9:627–631.

    Article  PubMed  Google Scholar 

  14. Dowaki S, Kijima H, Kashiwagi H, Tobita K, Ohtani Y, Sugio Y, et al. Undifferentiated spindle and giant cell carcinoma of the common bile duct. Tokai J Exp Clin Med 2003;28:127–130.

    PubMed  Google Scholar 

  15. Yoon GS, Choi DL. Sarcomatoid carcinoma of common bile duct: a case report. Hepatogastroenterology 2004;51:106–109.

    PubMed  Google Scholar 

  16. Oikawa H, Oka K, Nagakura S, Fukunaga M, Sando N, Kashimura J, et al. Spindle and giant cell type undifferentiated carcinoma arising in the common bile duct: a case report. Pathol Res Pract 2007;203:179–184.

    Article  PubMed  Google Scholar 

  17. Nakanishi Y, Ito T, Kubota K, Takeda H, Yonemori A, Kawakami H, et al. Spindle cell-type undifferentiated carcinoma of the common bile duct of the hepatic hilus: report of a case. Surg Today 2007;37:708–712.

    Article  PubMed  Google Scholar 

  18. Sobin LH, Wittekind C. TNM/pTNM classifi cation of malignant tumors. Berlin Heidelberg New York Tokyo: Springer; 2002.

    Google Scholar 

  19. Albores-Saavedra J, Henson DE, Klimstra DS. Tumor of the gallbladder, extrahepatic bile ducts, and ampulla of Vater. Atlas of tumor pathology. Third series fascicle 27. Washington DC: Armed Forces Institute of Pathology; 2000. p. 96–103.

    Google Scholar 

  20. Hamilton SR, Aaltonen LA. World Health Organization classification of tumors. Pathology and genetics of tumors of the digestive system. Lyon: IARC Press; 2000. p. 206–214.

    Google Scholar 

  21. Ben-Ze’ev A. Differential control of cytokeratins and vimentin synthesis by cell-cell contact and cell spreading in cultured epithelial cells. J Cell Biol 1984;99:1424–1433.

    Article  PubMed  Google Scholar 

  22. Ueyama T, Nagai E, Yao T, Tsuneyoshi M. Vimentin-positive gastric carcinomas with rhabdoid features. A clinicopathologic and immunohistochemical study. Am J Surg Pathol 1993;17:813–819.

    Article  PubMed  CAS  Google Scholar 

  23. Shinoda M, Shimazu M, Mukai M, Tanabe M, Hashiguchi N, Oda M, et al. Spindle cell carcinoma of the intrahepatic bile duct in a patient with primary sclerosing cholangitis. J Gastroenterol 2003;38:1091–1096.

    Article  PubMed  Google Scholar 

  24. Diebold-Berger S, Vaiton JC, Pache JC, d’Amore ES. Undifferentiated carcinoma of the gallbladder. Report of a case with immunohistochemical findings. Arch Pathol Lab Med 1995;119:279–282.

    PubMed  CAS  Google Scholar 

  25. Yamamoto J, Kosuge T, Shimada K, Takayama T, Yamasaki S, Ozaki H, et al. Intrahepatic cholangiocarcinoma: proposal of new macroscopic classifi cation (in Japanese with English abstract). Nippon Geka Gakkai Zasshi 1993;94:1194–1200.

    PubMed  CAS  Google Scholar 

  26. Suh KS, Roh HR, Koh YT, Lee KU, Park YH, Kim SW. Clinicopathologic features of the intraductal growth type of peripheral cholangiocarcinoma. Hepatology 2000;31:12–17.

    Article  PubMed  CAS  Google Scholar 

  27. Lucidi V, Van Laethem JL, Serste T, Gelin M, Donckier V. Peripheral cholangiocarcinoma with endoluminal tumor thrombus in main bile duct mimicking a Klatskin tumor. J Gastrointest Surg 2008;12:1149–1150.

    Article  PubMed  CAS  Google Scholar 

  28. Saito S, Hosoya Y, Arai W, Hyodo M, Yokoyama T, Hirashima Y, et al. Undifferentiated carcinoma of the esophagus (non-small cell type); a case report and review of the literature in Japan (in Japanese with English abstract). Jpn J Gastroenterol Surg 2005;38:19–24.

    Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Kokura Memorial Hospital, 1-1 Kifune, Kokurakita-ku, Kitakyushu, Fukuoka, 802-8555, Japan

    Takahisa Fujikawa, Akira Tanaka, Toshihiro Abe, Hironori Yoshimoto, Yukio Tokumitsu, Seiichiro Tada, Yoshiharu Matsumoto & Hisatsugu Maekawa

  2. Department of Gastroenterology, Kokura Memorial Hospital, 1-1 Kifune, Kokurakita-ku, Kitakyushu, Fukuoka, 802-8555, Japan

    Koji Aoyama & Kei Shiraishi

  3. Department of Pathology, Kokura Memorial Hospital, 1-1 Kifune, Kokurakita-ku, Kitakyushu, Fukuoka, 802-8555, Japan

    Tadaaki Yokota

Authors
  1. Takahisa Fujikawa
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  2. Akira Tanaka
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  3. Toshihiro Abe
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  4. Hironori Yoshimoto
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  7. Yoshiharu Matsumoto
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Fujikawa, T., Tanaka, A., Abe, T. et al. Undifferentiated carcinoma of the common bile duct with intraductal tumor thrombi: Report of a case. Surg Today 41, 579–584 (2011). https://doi.org/10.1007/s00595-009-4304-2

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  • DOI: https://doi.org/10.1007/s00595-009-4304-2

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