Sarcomatoid Carcinoma Of Gallbladder Research Articles

Gallbladder Sarcomatoid Carcinoma Diagnosed after Surgery

Sarcomatoid carcinoma is rarely diagnosed as gallbladder cancer. Its aggressive nature, due to the characteristics of both sarcoma and carcinoma, results in a poor prognosis. We report a case of gallbladder sarcomatoid carcinoma in an 82-year-old male who was referred to our hospital for evaluation of gallbladder cancer observed on abdominopelvic computed tomography. The characteristics of the cancer were not confirmed after several imaging modalities. The surgically resected tumor was positive for both cytokeratin and vimentin as revealed via immunohistochemical staining, and a sarcomatoid carcinoma was finally diagnosed. The role of chemotherapy has not yet been identified. Therefore, radiation therapy is planned to reduce the risk of recurrence.

123P Sarcomatoid carcinoma of gall bladder: A series of 14 cases from a single tertiary-care oncology centre

Gallbladder carcinoma (GBC) is a rare malignancy with an annual incidence of 1–2 cases per 100,000 persons in the United States. The aim of the study was to evaluate the frequency of sarcomatoid differentiation in GBCs and to assess their behaviour and outcomes.

Clinicopathological characteristics and outcome of primary sarcomatoid carcinoma of the gallbladder

PurposeOur study aims to examine the clinicopathological features, disease progression, management, and outcomes of gallbladder sarcomatoid carcinoma (GBSC) patients.MethodsBetween January 2000 and December 2020, 50 gallbladder cancer (GBC) patients who received surgical treatment and were pathologically verified as GBSC at our institution were enrolled. The clinical and pathological features and survival of these patients were retrospectively reviewed.ResultsThe median overall survival (OS) of GBSC patients was 14.5 months, and the 1-, 2- and 3-year OS rates were 68.0%, 32.0%, and 10.0%, respectively. The median progression-free survival (PFS) was 10.0 months, and the 1-, 2-, and 3-year PFS rates were 42.0%, 16.0%, and 2.0%, respectively. Patients who received radical resection had obviously better OS (18.0 vs. 7.0 months, P<0.001) and PFS (12.0 vs. 5.0 months, P<0.001) than those who underwent palliative resection. Multivariate analysis revealed that vascular invasion (P=0.033), curative operation (P<0.001) and postoperative chemotherapy (P=0.033) were independent risk factors for PFS. We further identified postoperative chemotherapy (P=0.010) and curative operation (P<0.001) as independent prognostic factors affecting the OS of GBSC patients. After curative surgery, patients who underwent S-1-based chemotherapy showed significantly longer recurrence-free survival (RFS) than those who underwent other chemotherapy regimens (20.0 vs 11.0 months, P=0.028).ConclusionGBSC patients always have aggressive biological behaviors and remarkably poor prognoses. Most GBSC patients are diagnosed in advanced stages, and timely radical operation together with postoperative chemotherapy is important. S-1-based chemotherapy may be a selectively efficient regimen to prolong the survival of GBSC patients.

Sarcomatoid Carcinoma of the Gallbladder: A Case Report and Literature Review

Sarcomatoid carcinoma of the gallbladder is a highly malignant tumor originating from totipotent mesenchymal stem cells, accounting for only 4.1% of gallbladder cancers. Its clinical manifestations are very similar to adenocarcinoma of the gallbladder, mainly presenting in the digestive tract. Surgical resection is currently the only possible cure for sarcomatoid carcinoma of the gallbladder. Due to the lack of effective diagnostic means at early stage, many patients have reached the middle and late stage of diagnosis, and the prognosis is often poor. In this paper, we present a case of a 52-year-old woman with advanced and rapidly progressing sarcomatoid carcinoma of the gallbladder causing obstructive cholangitis. She developed bone marrow suppression after immunotherapy combined with chemotherapy. The patient died after symptomatic and supportive treatment. This paper reports the whole process of diagnosis and treatment in this case of gallbladder sarcomatoid carcinoma, thus carring out a discussion based on relevant literaturea and providing a reference for treatment.

Guidance to rational use of pharmaceuticals in gallbladder sarcomatoid carcinoma using patient-derived cancer cells and whole exome sequencing.

PurposeGallbladder sarcomatoid carcinoma is a rare cancer with no clinical standard treatment. With the rapid development of next generation sequencing, it has been able to provide reasonable treatment options for patients based on genetic variations. However, most cancer drugs are not approval for gallbladder sarcomatoid carcinoma indications. The correlation between drug response and a genetic variation needs to be further elucidated.Experimental DesignThree patient-derived cells-JXQ-3D-001, JXQ-3D-002, and JXQ-3D-003, were derived from biopsy samples of one gallbladder sarcomatoid carcinoma patient with progression and have been characterized. In order to study the relationship between drug sensitivity and gene alteration, genetic mutations of three patient-derived cells were discovered by whole exome sequencing, and drug screening has been performed based on the gene alterations and related signaling pathways that are associated with drug targets.ResultsIt has been found that there are differences in biological characteristics such as morphology, cell proliferation, cell migration and colony formation activity among these three patient-derived cells although they are derived from the same patient. Their sensitivities to the chemotherapy drugs-Fluorouracil, Doxorubicin, and Cisplatin are distinct. Moreover, none of common chemotherapy drugs could inhibit the proliferations of all three patient-derived cells. Comprehensive analysis of their whole exome sequencing demonstrated that tumor-associated genes TP53, AKT2, FGFR3, FGF10, SDHA, and PI3KCA were mutated or amplified. Part of these alterations are actionable. By screening a set of compounds that are associated with the genetic alteration, it has been found that GDC-0941 and PF-04691502 for PI3K-AKT-mTOR pathway inhibitors could dramatically decrease the proliferation of three patient-derived cells. Importantly, expression of phosphorylated AKT and phosphorylated S6 were markedly decreased after treatments with PI3K-AKT-mTOR pathway inhibitors GDC-0941 (0.5 μM) and PF-04691502 (0.1 μM) in all three patient-derived cells. These data suggested that inhibition of the PI3K-AKT-mTOR pathway that was activated by PIK3CA amplification in all three patient-derived cells could reduce the cell proliferation.ConclusionsA patient-derived cell model combined with whole exome sequencing is a powerful tool to elucidate relationship between drug sensitivities and genetic alternations. In these gallbladder sarcomatoid carcinoma patient-derived cells, it is found that PIK3CA amplification could be used as a biomarker to indicate PI3K-AKT-mTOR pathway activation. Block of the pathway may benefit the gallbladder sarcomatoid carcinoma patient with this alternation in hypothesis. The real efficacy needs to be confirmed in vivo or in a clinical trial.

Gallbladder sarcomatoid carcinoma: A case report and review of current literature

Summary Gallbladder sarcomatoid carcinoma is a rare neoplasm characterized by the simultaneous presence of malignant epithelial and mesenchymal components. There is little information about the clinical behavior and optimal treatment for these tumors. The current study examines the case of a 52-year-old female patient who presented with postprandial epigastric pain that had persisted for 1 year. A diagnosis of gallbladder sarcomatoid carcinoma was confirmed by pathology after radical resection. Peritoneal metastasis occurred 3 months later, and the patient died 6 months after diagnosis. This study found that the prognosis of gallbladder sarcomatoid carcinoma is poor even after curative resection and there is as yet no known effective adjuvant therapy.

胆囊腺筋腫症に発生した胆囊肉腫様癌の1例

胆囊腺筋腫症に発生した胆囊肉腫様癌の1例

Case Series Analysis of Gallbladder Sarcomatoid Carcinoma

Case Series Analysis of Gallbladder Sarcomatoid Carcinoma

Surgical management of gallbladder sarcomatoid carcinoma

To study the behavior as well as optimal treatment of gallbladder sarcomatoid carcinoma, we reviewed the results of treatment of gallbladder sarcomatoid carcinoma from Chang Gung Memorial Hospital. From 1987 to 2005, six patients were diagnosed with gallbladder sarcomatoid carcinoma and treated at our institution. Tumor staging was based on 2002 revised tumor-node-metastasis (TNM) staging for gall bladder cancer from the American Joint Committee on Cancer. The clinical presentation, laboratory data and preoperative workup were reviewed retrospectively. Five patients were female and one was male. The age ranged from 51 to 66 years (median, 58 years). Surgical procedures included three curative resections, two palliative resections and one biopsy. There were two surgical complications (33.3%) and one case of surgical mortality (16.7%). The follow-up time ranged from 30 d to 5 mo. The median survival was 2.5 mo. The prognosis was extremely poor, even after curative resection and postoperative chemotherapy. The prognosis of gallbladder sarcomatoid carcinoma was not dependent on TNM stage and was always dismal. The clinicopathological features were different from those of gall bladder cancer.

One case of gallbladder sarcomatoid carcinoma

病人男性,62岁,因发现右上腹肿块伴腹部不适及消瘦1月余入院.曾餐后呕吐胃内容物数次,发病以来体重减轻5 kg,腹部肿块明显增大.查体:神清,皮肤巩膜无黄染,浅表淋巴结未及,右上腹明显隆起,可及约17 cm×17 cm×5cm肿块,质中,界欠清,表面欠光滑,不能推动.CT示右上腹腔囊实性肿块,与肝左叶、胆囊、胃窦分界不清,考虑恶性肿瘤可能大;左肝内胆管结石。