Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. May 15, 2024; 16(5): 2253-2260
Published online May 15, 2024. doi: 10.4251/wjgo.v16.i5.2253
Undifferentiated high-grade pleomorphic sarcoma of the common bile duct: A case report and review of literature
Li-Ping Zheng, Wen-Yan Shen, Chun-Dong Hu, Chun-Hua Wang, Xu-Jian Chen, Jing Wang, Yi-Yu Shen
Li-Ping Zheng, Chun-Dong Hu, Xu-Jian Chen, Jing Wang, Yi-Yu Shen, Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Wen-Yan Shen, Chun-Hua Wang, Department of Pathology, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Co-first authors: Li-Ping Zheng and Wen-Yan Shen.
Co-corresponding authors: Jing Wang and Yi-Yu Shen.
Author contributions: Zheng LP, Wang J and Shen YY concepted and designed the case report; Zheng LP, Shen WY and Hu CD collected the clinicopathologic data of the patient; Shen WY and Wang CH provided and explained the pathological pictures; Zheng LP, Shen WY, Chen XJ, Wang J and Shen YY analyzed the data; Zheng LP, Wang J and Shen YY wrote the manuscript; All the authors have read and approved the final manuscript. Zheng LP conceived, designed the case, collected and analyzed the data, and wrote the first draft of the manuscript. Shen WY was responsible for the collection and processing of tissue specimens, as well as pathological diagnosis. Both authors have made vital and indispensable contributions to the completion of the case and are therefore eligible to be co-first authors of the paper. As co-corresponding authors, Wang J and Shen YY played an important and indispensable roles in case design, data analysis and manuscript preparation.
Supported by the People’s Livelihood Science and Technology Innovation Project of the Bureau of Science and Technology of Jiaxing City, No. 2021AD30091.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Yu Shen, MD, Chief Physician, Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, No. 1518 Huancheng North Road, Jiaxing 314000, Zhejiang Province, China. drzlping@126.com
Received: January 24, 2024
Peer-review started: January 24, 2024
First decision: January 31, 2024
Revised: February 7, 2024
Accepted: March 25, 2024
Article in press: March 25, 2024
Published online: May 15, 2024
Processing time: 106 Days and 1.5 Hours
Abstract
BACKGROUND

Undifferentiated pleomorphic sarcoma (UPS) is a rare malignant mesenchymal tumor with a poor prognosis. It mainly occurs in the extremities, trunk, head and neck, and retroperitoneum regions. Owing to the lack of specific clinical manifestations and imaging features, UPS diagnosis mainly depends on pathological and immunohistochemical examinations for exclusive diagnosis. Here we report an extremely rare case of high-grade UPS in the common bile duct (CBD). There are limited available data on such cases.

CASE SUMMARY

A 70-year-old woman was admitted to our department with yellow eyes and urine accompanied by upper abdominal distending pain for 2 wk. Her laboratory data suggested significantly elevated hepatorenal function levels. The imaging data revealed calculous cholecystitis, intrahepatic and extrahepatic bile duct dilation with extrahepatic bile duct calculi, and a space-occupying lesion at the distal CBD. After endoscopic biliary stenting and symptomatic support therapy, CBD exploration and biopsy were performed. The frozen section indicated malignant spindle cell tumor of the CBD mass, and further radical pancreaticoduodenectomy was performed. Finally, the neoplasm was diagnosed as a high-grade UPS combined with the light-microscopic morphology and immunohistochemical results.

CONCLUSION

This extremely rare case highlighted the need for increasing physicians' vigilance, reducing the odds of misdiagnosis, and providing appropriate treatment strategies.

Keywords: Undifferentiated pleomorphic sarcoma; Soft tissue sarcoma; Common bile duct; Extrahepatic bile duct; Immunohistochemistry; Case report

Core Tip: Undifferentiated pleomorphic sarcoma (UPS) cases are rare. Herein, we report the case of an elderly woman with high-grade UPS, which was detected because of obstructive jaundice and diagnosed by histopathology. As far as we know, this is the first reported case of UPS in the common bile duct (CBD). Recognizing that UPS can occur in the CBD will help increase physicians' vigilance, reduce the odds of misdiagnosis, and provide appropriate treatment strategies.