A Case of Multiple Carcinoma of the Gallbladder

Kouichi Nakayama, Masami Hoshino, Toshiyuki Ono, Yoshihisa Koyama, Norio Inoue, Atsuo Tsuchiya, Rikiya Abe

The Second Department of Surgery, Fukushima Medical College

A case of advanced gallbladder cancer of different histological types is reported. The patient was a 78-year-old woman complaining of right upper abdominal pain. A low echogenic mass in the left hepatic lobe and multiple strong echos with acoustic shadows in the gallbladder were detected by ultrasonographic examination. Endoscopic retrograde cholangiopancreatography revealed multiple shadow defects within the gallbladder and choledochus, and compression and dilatation of the choledochus. On the celiac arterial angiogram, hypervascular lesions were seen in the left hepatic artery, the gastroduodenal artery and the cystic artery areas. A diagnosis of cholelithiasis and gallbladder carcinoma with hepatic and lymphnode metastasis was made. Extended cholecystectomy with lymphnode dissection and partial hepatectomy were performed. Two separated tumors were revealed in the resected gallbladder, one 2.0×2.0×0.1 cm, the other 0.6×0.6×0.5 cm. Histologically, these two tumors were composed of adenosquamous cell carcinoma and adenocarcinoma respectively. Lymphnode and hepatic metastases were composed of squamous cell carcinoma alone.

Key words
multipe carcinomas of the gallbladder, adenosquamous cell carcinoma

Reprint requests
Kouichi Nakayama Second Department of Surgery, Fukushima Medical College
1 Hikarigaoka, Fukushima, 960-12 JAPAN

Accepted
April 17, 1991

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