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.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
K Matsui M Kitagawa (1991) ArticleTitleSpindle cell carcinoma of the lung. A clinicopathologic study of three cases Cancer 67 2361–7 Occurrence Handle1707339
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
H Battifora (1976) ArticleTitleSpindle cell carcinoma: ultrastructural evidence of squamous origin and collagen production by the tumor cells Cancer 37 2275–82 Occurrence Handle1260715
JR Goellner KD Devine LH Weiland (1973) ArticleTitlePseudosarcoma of the larynx Am J Clin Pathol 59 312–26 Occurrence Handle4687349
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
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
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
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
HD Appelman N Coopersmith (1970) ArticleTitlePleomorphic spindle-cell carcinoma of the gallbladder. Relation to sarcoma of the gallbladder Cancer 25 535–41 Occurrence Handle5416826
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
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
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
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
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
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
J Haratake A Horie (1991) ArticleTitleAn immunohistochemical study of sarcomatoid liver carcinomas Cancer 68 93–7 Occurrence Handle1710948
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
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
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
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
H Kubosawa H Ishige Y Kondo A Konno T Yamamoto K Nagao (1988) ArticleTitleHepatocellular carcinoma with rhabdomyoblastic differentiation Cancer 62 781–6 Occurrence Handle2840192
K Nomura S Aizawa S Ushigome (2000) ArticleTitleCarcinosarcoma of the liver Arch Pathol Lab Med 124 888–90 Occurrence Handle10835528
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
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
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
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
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
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
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
Author information
Authors and Affiliations
Rights 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
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s00535-005-1684-y