Skip to main content

Advertisement

SpringerLink
Log in

Primary undifferentiated spindle-cell carcinoma of the gallbladder presenting as a liver tumor

  • Case report
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Undifferentiated spindle-cell carcinoma (SpCC) of the gallbladder is extremely rare. There is very little information available regarding the characteristics and treatment of this disease. We herein report the unique case of a 76-year-old female patient with a primary SpCC of the gallbladder that presented as a liver tumor. Preoperative radiologic examinations showed a 5-cm liver tumor around the gallbladder bed, and irregular thickening of the gallbladder wall. The patient underwent en-bloc resection of the gallbladder and segments 4b and 5 of the liver (including the liver tumor). Microscopic findings revealed that both lesions consisted mainly of a sarcomatous spindle-shaped component. Small foci of well-differentiated adenocarcinoma cells were identified in the gallbladder mucosa. There was a gradual transition between the two different components, thereby implying that these two cell types had a common origin. Immunohistochemical studies showed that the spindle-shaped cells were epithelial in nature. The patient's postoperative course was uneventful. However, she died of recurrent liver disease 6 months after the surgery. In conclusion, we surmised that the sarcomatous spindle cells originated from a carcinomatous component in the gallbladder mucosa through dedifferentiation. Further studies are needed to better understand the characteristics of this deadly tumor, and to establish an effective therapy for it.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. K Matsui M Kitagawa (1991) ArticleTitleSpindle cell carcinoma of the lung. A clinicopathologic study of three cases Cancer 67 2361–7 Occurrence Handle1707339

    PubMed  Google Scholar 

  2. T Hirose T Sano J Abe K Hizawa T Mori (1987) ArticleTitleSpindle cell carcinoma of the uterus Acta Pathol Jpn 37 997–1002 Occurrence Handle3307294

    PubMed  Google Scholar 

  3. H Battifora (1976) ArticleTitleSpindle cell carcinoma: ultrastructural evidence of squamous origin and collagen production by the tumor cells Cancer 37 2275–82 Occurrence Handle1260715

    PubMed  Google Scholar 

  4. JR Goellner KD Devine LH Weiland (1973) ArticleTitlePseudosarcoma of the larynx Am J Clin Pathol 59 312–26 Occurrence Handle4687349

    PubMed  Google Scholar 

  5. RJ Zarbo JD Crissman H Venkat MA Weiss (1986) ArticleTitleSpindle-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 10 741–53 Occurrence Handle2430474

    PubMed  Google Scholar 

  6. SS Robey-Cafferty DJ Grignon JY Ro KR Cleary AG Ayala NG Ordonez et al. (1990) ArticleTitleSarcomatoid carcinoma of the stomach. A report of three cases with immunohistochemical and ultrastructural observations Cancer 65 1601–6 Occurrence Handle2178769

    PubMed  Google Scholar 

  7. IO Ellis J Bell JE Ronan CW Elston RW Blamey (1988) ArticleTitleImmunocytochemical investigation of intermediate filament proteins and epithelial membrane antigen in spindle cell tumours of the breast J Pathol 154 157–65 Occurrence Handle10.1002/path.1711540208 Occurrence Handle2450980

    Article  PubMed  Google Scholar 

  8. MR Wick BA Brown RH Young SE Mills (1988) ArticleTitleSpindle-cell proliferations of the urinary tract. An immunohistochemical study Am J Surg Pathol 12 379–89 Occurrence Handle3284397

    PubMed  Google Scholar 

  9. HD Appelman N Coopersmith (1970) ArticleTitlePleomorphic spindle-cell carcinoma of the gallbladder. Relation to sarcoma of the gallbladder Cancer 25 535–41 Occurrence Handle5416826

    PubMed  Google Scholar 

  10. S Suster M Huszar E Herczeg JJ Bubis (1987) ArticleTitleAdenosquamous carcinoma of the gallbladder with spindle cell features. A light microscopic and immunocytochemical study of a case Histopathology 11 209–14 Occurrence Handle2437004

    PubMed  Google Scholar 

  11. KJ Guo K Yamaguchi M Enjoji (1988) ArticleTitleUndifferentiated carcinoma of the gallbladder. A clinicopathologic, histochemical, and immunohistochemical study of 21 patients with a poor prognosis Cancer 61 1872–9 Occurrence Handle2451557

    PubMed  Google Scholar 

  12. K Nishihara M Tsuneyoshi (1993) ArticleTitleUndifferentiated spindle cell carcinoma of the gallbladder: a clinicopathologic, immunohistochemical, and flow cytometric study of 11 cases Hum Pathol 24 1298–305 Occurrence Handle10.1016/0046-8177(93)90263-G Occurrence Handle8276377

    Article  PubMed  Google Scholar 

  13. T Hotta H Tanimura S Yokoyama K Ura H Yamaue (2002) ArticleTitleSocalled carcinosarcoma of the gallbladder; spindle cell carcinoma of the gallbladder: report of a case Surg Today 32 462–7 Occurrence Handle10.1007/s005950200077 Occurrence Handle12061703

    Article  PubMed  Google Scholar 

  14. A Arakawa H Fujii T Matsumoto S Hirai K Suda (2004) ArticleTitleLoss of heterozygosity in clonal evolution with genetic progression and divergence in spindle cell carcinoma of the gallbladder Hum Pathol 35 418–23 Occurrence Handle10.1016/j.humpath.2003.10.026 Occurrence Handle15116321

    Article  PubMed  Google Scholar 

  15. DE Henson J Albores-Saavedra D Corle (1992) ArticleTitleCarcinoma of the gallbladder. Histologic types, stage of disease, grade, and survival rates Cancer 70 1493–7 Occurrence Handle1516000

    PubMed  Google Scholar 

  16. J Haratake A Horie (1991) ArticleTitleAn immunohistochemical study of sarcomatoid liver carcinomas Cancer 68 93–7 Occurrence Handle1710948

    PubMed  Google Scholar 

  17. M Sasaki Y Nakanuma Y Nagai A Nonomura (1991) ArticleTitleIntrahepatic cholangiocarcinoma with sarcomatous transformation: an autopsy case J Clin Gastroenterol 13 220–5 Occurrence Handle1851775

    PubMed  Google Scholar 

  18. P Bertram KH Treutner L Tietze V Schumpelick (1997) ArticleTitleTrue carcinosarcoma of the colon. Case report Langenbecks Arch Chir 382 173–4 Occurrence Handle10.1007/s004230050049 Occurrence Handle9239638

    Article  PubMed  Google Scholar 

  19. Y Nakakubo S Okushiba K Ohno K Ito K Sato T Morikawa et al. (2001) ArticleTitleTrue carcinosarcoma of the esophagus with osteosarcoma Hepatogastroenterology 48 137–9 Occurrence Handle11268949

    PubMed  Google Scholar 

  20. A Fayyazi W Nolte JW Oestmann B Sattler G Ramadori HJ Radzun (1998) ArticleTitleCarcinosarcoma of the liver Histopathology 32 385–7 Occurrence Handle10.1046/j.1365-2559.1998.0401j.x Occurrence Handle9602346

    Article  PubMed  Google Scholar 

  21. H Kubosawa H Ishige Y Kondo A Konno T Yamamoto K Nagao (1988) ArticleTitleHepatocellular carcinoma with rhabdomyoblastic differentiation Cancer 62 781–6 Occurrence Handle2840192

    PubMed  Google Scholar 

  22. K Nomura S Aizawa S Ushigome (2000) ArticleTitleCarcinosarcoma of the liver Arch Pathol Lab Med 124 888–90 Occurrence Handle10835528

    PubMed  Google Scholar 

  23. M Kojiro S Sugihara S Kakizoe O Nakashima K Kiyomatsu (1989) ArticleTitleHepatocellular carcinoma with sarcomatous change: a special reference to the relationship with anticancer therapy Cancer Chemother Pharmacol 23 S4–8 Occurrence Handle10.1007/BF00647229 Occurrence Handle2466583

    Article  PubMed  Google Scholar 

  24. R Kawano Y Takeshima K Inai (1996) ArticleTitleAlteration of the p53 gene of lung carcinomas with sarcomatous transformation (spindle cell carcinoma): analysis of four cases Pathol Int 46 38–45 Occurrence Handle10846548

    PubMed  Google Scholar 

  25. RL Goldman N Weidner (1993) ArticleTitlePure squamous cell carcinoma of the larynx with cervical nodal metastasis showing rhabdomyosarcomatous differentiation. Clinical, pathologic, and immunohistochemical study of a unique example of divergent differentiation Am J Surg Pathol 17 415–21 Occurrence Handle8494107

    PubMed  Google Scholar 

  26. S Hatakeyama M Satoh N Yoshimura T Otsu (1994) ArticleTitleImmunocytochemical localization of bone morphogenetic proteins (BMPs) in salivary gland pleomorphic adenoma J Oral Pathol Med 23 232–6 Occurrence Handle7519267

    PubMed  Google Scholar 

  27. Y Shirai T Ohtani K Tsukada K Hatakeyama (1997) ArticleTitleCombined pancreaticoduodenectomy and hepatectomy for patients with locally advanced gallbladder carcinoma: long term results Cancer 80 1904–9 Occurrence Handle10.1002/(SICI)1097-0142(19971115)80:10<1904::AID-CNCR5>3.0.CO;2-N Occurrence Handle9366291

    Article  PubMed  Google Scholar 

  28. M Miyazaki H Itoh S Ambiru H Shimizu A Togawa E Gohchi et al. (1996) ArticleTitleRadical surgery for advanced gallbladder carcinoma Br J Surg 83 478–81 Occurrence Handle8665234

    PubMed  Google Scholar 

  29. Y Shirai K Yoshida K Tsukada T Muto H Watanabe (1992) ArticleTitleRadical surgery for gallbladder carcinoma. Long-term results Ann Surg 216 565–8 Occurrence Handle1359844

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Tomotaka Akatsu, Masakazu Ueda, Motohide Shimazu, Go Wakabayashi, Koichi Aiura, Minoru Tanabe, Shigeyuki Kawachi & Masaki Kitajima

  2. Division of Diagnostic Pathology, Keio University School of Medicine, Tokyo, Japan

    Kaori Kameyama

Authors
  1. Tomotaka Akatsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masakazu Ueda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Motohide Shimazu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Go Wakabayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Koichi Aiura
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Minoru Tanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shigeyuki Kawachi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kaori Kameyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Masaki Kitajima
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Akatsu, T., Ueda, M., Shimazu, M. et al. Primary undifferentiated spindle-cell carcinoma of the gallbladder presenting as a liver tumor. J Gastroenterol 40, 993–998 (2005). https://doi.org/10.1007/s00535-005-1684-y

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00535-005-1684-y

Key words

Search

Navigation