Sarcomatoid carcinoma of the common bile duct

RATIONALE Sarcomatoid carcinoma is an extremely rare lesion in the common bile duct (CBD). PATIENT CONCERNS We present a case of sarcomatoid carcinoma of the distal CBD in a 51-year-old woman who presented with jaundice and abdominal pain. Whipple's operation was performed successfully. Microscopically, the tumor was a poorly differentiated carcinoma containing a component of sarcoma-like differentiation. The tumor cells displayed spindle-shaped nuclei with occasional mitotic figures. Cytokeratin (CK) 7, CK19, CK18, and pan-CK (AE1/AE3) staining was positive on immunohistochemistry. Vimentin and carcinoembryonic antigen (CEA) staining were also positive. DIAGNOSES Sarcomatoid carcinoma of the distal CBD. INTERVENTIONS The patient received three cycles of chemotherapy after surgery. OUTCOMES The patient has experienced no adverse events in the 3 years post-surgery. LESSONS We present here a case report of sarcomatoid carcinoma of the distal CBD. The patient received chemotherapy after surgery, and was event-free for 3 years post-surgery, suggesting a relatively better prognosis, despite the infiltrative pattern of the tumor.