Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2024; 12(10): 1817-1823
Published online Apr 6, 2024. doi: 10.12998/wjcc.v12.i10.1817
Gallbladder carcinosarcoma with a poor prognosis: A case report
Yi Dai, Min Meng, Qi-Zhi Luo, Yuan-Jun Liu, Fan Xiao, Chun-Hua Wang
Yi Dai, Fan Xiao, Chun-Hua Wang, Department of Hepatobiliary Surgery, Suining Central Hospital, Suining 629000, Sichuan Province, China
Min Meng, The Cancer Center, Suining Central Hospital, Suining 629000, Sichuan Province, China
Qi-Zhi Luo, Department of Pathology, Suining Central Hospital, Suining 629000, Sichuan Province, China
Yuan-Jun Liu, Department of Liver Surgery & Liver Transplantation, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Dai Y designed the study, performed the surgery, and managed the patients; Meng M provided the oncology data; Luo QZ provided the pathological data and analysis; Liu YJ, Xiao F, and Wang CH managed the patients and signed the treatment and study consent forms; All authors have read and approve the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and all accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: We have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi Dai, MD, Chief Physician, Department of Hepatobiliary Surgery, Suining Central Hospital, No. 127 West Desheng Road, Chuanshan District, Suining 629000, Sichuan Province, China. 158650601@qq.com
Received: November 23, 2023
Peer-review started: November 23, 2023
First decision: January 9, 2024
Revised: February 3, 2024
Accepted: March 8, 2024
Article in press: March 8, 2024
Published online: April 6, 2024
Abstract
BACKGROUND

Carcinosarcoma of the gallbladder is a rare malignant tumor with a very poor prognosis. To date, only approximately 100 patients have been reported in the English literature. The prognosis of this tumor type is poor, the preoperative diagnosis is difficult, and there is a possibility of a misdiagnosis. We present an unsuccessful case of carcinosarcoma of the gallbladder with a preoperative misdiagnosis and rapid early postoperative recurrence. Therefore, we have a deeper understanding of the poor prognosis of gallbladder carcinosarcoma (GBC) patients.

CASE SUMMARY

The patient is a 65-year-old male. He was admitted to the hospital because of right upper abdomen distending pain and discomfort for half a month. Abdominal magnetic resonance imaging revealed a polycystic mass in the right lobe of the liver and the fossa of the gallbladder. After admission, the patient was diagnosed with a liver abscess, which was treated by abscess puncture drainage. Obviously, this treatment was unsuccessful. Hepatectomy and cholecystectomy were performed one month after the puncture. Postoperative pathologic examination revealed carcinosarcoma of the gallbladder, and the resected specimen contained two tumor components. One month after surgery, the patient's tumor recurred in situ and started to compress the duodenum, resulting in duodenal obstruction and bleeding. The treatment was not effective. The patient died of gastrointestinal hemorrhage and hypovolemic shock.

CONCLUSION

Carcinosarcoma of the gallbladder is a rare malignant tumor that is easily misdiagnosed preoperatively and has a poor prognosis.

Keywords: Gallbladder disease, Carcinosarcoma, Misdiagnosis, Poor prognosis, Pathological diagnosis, Recurrence, Case report

Core Tip: Herein, we report a patient with carcinosarcoma of the gallbladder who was diagnosed with a liver abscess before surgery due to radiographic polycystic features of the liver. Then, the wrong treatment was administered. After surgical removal of the tumor, the tumor rapidly recurred locally and caused obstruction and bleeding of the digestive tract, leading to the patient’s death. We need to learn some lessons from this case.