A Case of Carcinoma of the Gallbladder, Presenting an Intraluminal Growth, Accompanied with Partial Transverse Septum across the Organ and Anomalous Arrangement of the Pancreaticobiliary Ductal System

Jun Itakura, Tomoki Fukazawa, Yuuji Iimuro, Toru Ishikawa, Keisuke Sakai, Yoshiro Matsumoto, Masatoshi Mogaki*, Koichi Suda*

First Department of Surgery and *Department of Pathology, Yamanashi Medical College

A 68-year-old woman was admitted to Yamanashi Medical College Hospital with chief complains of right hypochondralgia and back pain. Ultrasonography and computed tomography revealed a papillary growing tumor of the gallbladder and endoscopic retrograde cholangio pancreatography showed an anomalous arrangement of the pancreaticobiliary ductal system (AAPB). Extended cholecystectomy with dissection of the regional lymph nodes and resection of the bile duct, with biliary diversion, were performed. The resected specimen showed a partial transverse septum across the gallbladder and a cavity in the fundus occupied by a papillary growing tumor mass, of which the histological findings were papillary adenocarcinoma. The mucosa of the cavity in the neck had a normal appearance. Microscopic findings of the wall distal to the transverse septum showed proliferation of the ductal structure. Rokitansky-Aschoff sinus and dysplastic changes in the mucosa. These findings suggest that a mixture of bile and pancreatic juice caused by the AAPB and the septum was related to the pathogenesis of the gallbladder cancer in this patient.

Key words
carcinoma of the gallbladder, gallbladder with partial transverse septum, anomalous arrangement of the pancreatico-biliary ductal system

Reprint requests
Jun Itakura First Department of Surgery, Yamanashi Medical College
111-Tamaho-cyo, Nakakomagun, Yamanashi, 409-38 JAPAN

Accepted
October 9, 1991

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