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Carcinosarcoma of Gallbladder with Osteosarcomatous Differentiation — a Case Report with Review of Literature

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Indian Journal of Surgical Oncology Aims and scope Submit manuscript

Abstract

A 44-year-old female presented with dull upper abdominal pain. Contrast-enhanced computed tomography (CECT) of the abdomen revealed a well-distended gallbladder with multiple foci of minimally enhancing, intraluminal, soft tissue lesion, and hyperdensity on non-contrast scan measuring 4.3 × 3.5 cm in the fundus with few calculi embedded in it. There was no evidence of extraluminal extension. The patient underwent extended cholecystectomy with liver wedge resection. Histologically, the tumor showed both carcinomatous and sarcomatous components, with prominent osteosarcomatous differentiation. We report this unusual case and present a review of all cases of carcinosarcoma of the gallbladder with sarcomatous differentiation. Despite curative resection, CSGB prognosis remains poor, and thus, the authors recommend to focus their efforts to improve the surgical outcomes.

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Author information

Author notes

  1. Pallavi Prasad and Jyoti Verma authorized for first authorship due to equal contributions

Authors and Affiliations

  1. Department of Pathology, SGPGIMS, C Block, Raibarelli Road, Lucknow, UP, India

    Pallavi Prasad & Riti Yadav

  2. Department of Pathology, AIIMS, Second Floor, Room No. 219, College Building, Mangalagiri, 522503, Andhra Pradesh, India

    Jyoti Verma

  3. Department of Gastrosurgery, SGPGIMS, C Block, Raibarelli Road, Lucknow, 226014, UP, India

    Rajneesh Kumar Singh

Authors
  1. Pallavi Prasad
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  2. Jyoti Verma
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  3. Rajneesh Kumar Singh
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  4. Riti Yadav
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Contributions

Literature search, collection of data, and manuscript preparation were done by JV who acts as a guarantor also. I reported this case under faculty-in-charge PP during the tenure of my senior residency in SGPGIMS, Lucknow (2017–2020), and PP helped in framing and analysis of the data. The manuscript was written by JV, and the clinical portion was prepared by RKS. Literature search and the preparation of revised images of restained slides along with analysis of data were done by RY. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jyoti Verma.

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Patient’s verbal consent was obtained. There are no financial source of support.

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Our study is a case report which is exempted from the ethical approval in our institution.

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The participant has given verbal informed consent for the submission of the case report to the journal.

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Highlights

Carcinosarcoma of gallbladder (CSGB) also referred to as sarcomatoid carcinoma and malignant mixed tumor is an extremely rare neoplasm accounting to less than 1% of all the malignant tumors of gallbladder.

Carcinosarcoma of the gallbladder with prominent osteosarcomatous differentiation as a solitary heterologous element is all the more rare.

Microscopy shows an infiltrating tumor composed of both malignant epithelial and mesenchymal components.

On immunohistochemistry the malignant epithelial cells were positive for cytokeratin and negative for vimentin while the sarcomatous cells were positive for vimentin.

CSGB is a rare tumor composed of both malignant epithelial and mesenchymal components with a poorer prognosis than ordinary gallbladder adenocarcinoma.

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Prasad, P., Verma, J., Kumar Singh, R. et al. Carcinosarcoma of Gallbladder with Osteosarcomatous Differentiation — a Case Report with Review of Literature. Indian J Surg Oncol 13, 731–740 (2022). https://doi.org/10.1007/s13193-022-01552-4

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  • DOI: https://doi.org/10.1007/s13193-022-01552-4

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