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Hydatid disease or echinococcosis is a systemic zoonosis caused by Echinococcus granulosus larvae. We report the case of a 63 year-old Peruvian female patient who presented with diffuse abdominal pain and jaundice. An abdominal computed tomography (CT) scan was performed that showed a large hepatic hydatid cyst (6 x 6 cm) in segment IV with an apparent communication with the biliary duct. Laboratory results showed hemoglobin 13.2 g/dl, white blood cell (WBC) count 10,600 cell/mm3, normal serum amylase and lipase, total bilirubin 7,5 mg/dl, direct bilirubin 6,2 mg/dl and alkaline phosphatase 234 UI/l. Magnetic resonance cholangiopancreatography (MRCP) showed the same findings of the CT scan plus dilation of the biliary duct.

Carcinosarcomas, are very rare tumors in gastrointestinal tract, and at the ampulla of Vater location, are extremely uncommon. They are also called spindle cell carcinomas or sarcomatoid carcinomas. These tumors have an aggressive clinical course with frequent metastasis. We report the case of a male patient of 64 y.o with anemia and jaundice, and a diagnosis of carcinosarcoma of the ampulla of Vater.