PMC6838533_01
A: Computed tomography scans of the chest and the abdomen revealing a large polypoidal enhancing mass in the gallbladder measuring 11.5 x 9.2 x 5 cm with focal lesions in segment V. B: Coronal view of computed tomography scans of the chest and abdomen revealing a large gallbladder mass. C: Sagittal view of the same image.
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Computed tomography (CT) of the chest, abdomen, and pelvis revealed a large polypoidal enhancing mass in the gallbladder measuring 11.5 x 9.2 x 5 cm, and focal lesions in segment V of the liver with extension to the right colon; peritoneal deposits were also observed (Fig. 1A, B, and C).
A: HE staining (20x) of the epithelial component of carcinosarcoma. B: Negative on CK staining. C: Vimentin positivity in the sarcomatous component.
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Histopathological examination revealed a malignant tumour cells included epithelial components of carcinosarcoma, and were positive for vimentin and negative for cytokeratin (CK) (Fig. 2A, B, and C).
PMC6838533_02
A: Computed tomography scans of the chest and the abdomen revealing a distended gallbladder fundus with intraluminal tumour and huge exophytic mass measuring approximately 13.6 x 12 x 9.5 cm. B: Coronal view of the computed tomography scans of the chest and abdomen revealing a large gallbladder mass; medially the lesion is displacing the distal stomach at the level of pylorus, and the mass protruding downward is displacing the transverse colon inferiorly. Few small portal lymph nodes are observed. C: Sagittal view of the same image.
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Few small portal lymph nodes were also seen (Fig. 3A, B, and C).
A: HE staining (20x) of the epithelial component of carcinosarcoma. B: CK staining positivity in the carcinoma component. C: Vimentin positivity in the sarcomatous component.
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Immunohistochemical staining revealed positivity for both, CK (carcinomatous component) and vimentin (sarcomatous component) stains (Fig. 4A, B, and C).
PMC6838533_03
A: HE staining (20x) of the epithelial component of carcinosarcoma. B: CK staining positivity in the carcinomatous component: C: Vimentin positivity in the sarcomatous component.
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Immunohistochemical stains showed positivity for both, CK and vimentin stains in the carcinomatous and sarcomatous components, respectively (Fig. 5A, B, and C).
A: Positron emission tomography-CT of chest, abdomen, and pelvis revealing post-surgical changes in the liver with no focal uptake suggestive of local recurrence. Fatty changes are noted. A soft tissue lesion with areas of coarse calcification is seen in the anterior abdominal wall on the right, next to the midline; it is in close proximity to the site of the previous surgical incision, and measures 8.3 x 6.9 cm, with a maximum standardized uptake value of 6.5. B: Sagittal view of the same image.
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The PET-CT scans of the chest, abdomen, and pelvis demonstrated a soft tissue lesion with areas of coarse calcification in the anterior abdominal wall, next to the midline measuring 8.3 x 6.9 cm; it was located near the site of the previous surgical incision (Fig. 6A and B).
A: Coronal view of computed tomography scans of the chest and abdomen after 7 years from first surgery showing no local recurrence and no new lesions. B: Sagittal view of the same image.
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Her overall survival till date is 7 years and 2 months (86 months) from the first surgery, with no further recurrence of the tumour (Fig. 7A and B).