A Case of Alpha-Fetoprotein-producing Gallbladder Carcinoma with Extramural Growth

Kazuko Ito, Koji Hattori, Hiroaki Naruse, Hironori Tanaka, Hirotaka Kishikawa, Honda Kyuji

Department of Surgery, Nagoya City Higashi General Hospital

A 70-year-old woman with a large abdominal mass in the right hypochondrium was admitted to our hospital. A solid tumor was located below the right lobe of the liver and surrounded the fundus of the gallbladder. The gallbladder had some stones but no mucosal lesion were detected. The cystic duct was obstructed. Her serum carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) levels were elevated (CEA 17.0 ng/ml, AFP 2150 ng/ml). The biopsy specimen of the cervical lymph node showed adenocarcinoma. Laparotomy findings revealed that the tumor originated from a small portion of the fundus of the gallbladder, forming the large extramural mass. Cholecystectomy and partial resection of the liver and transverse colectomy were performed. The mucosa of the gallbladder had almost fallen off, but histological examination revealed that the tumor had invaded the whole wall. Postoperatively level of serum AFP decreased, but 7 months after the operation the patient died of recurrence. This growth seemed to have occurred in relation to the increase in the internal pressure of the gallbladder.

Key words
AFP-positive gallbladder carcinoma, gallbladder carcinoma forming extramural mass

Reprint requests
Kazuko Ito Department of Surgery, Nagoya City Higashi General Hospital
1-2-23 Wakamizu, Chikusa-ku, Nagoya, 464 JAPAN

Accepted
November 20, 1991

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