A Case of Undifferentiated Carcinoma of the Gallbladder

Shinpei Matsuyama, Seiji Kawasaki, Maki Murakami, Shinichi Miyagawa, Tohro Kakazu, Masatoshi Makuuchi, Keiko Ishii*

First Department of Surgery, Shinsyu University School of Medicine
*Central Clinical Laboratories, Shinsyu University Hospital

We report a case of undifferentiated carcinoma of the gallbladder in a 68-year-old woman who was admitted to our department with an abdominal tumor and obstructive jaundice. Under the preoperative diagnosis of gallbladder tumor, based on imaging findings and elevated levels of NSE, CEA, PIVKA-II and CA19-9, laparatomy was performed, revealing a primary tumor of the gallbladder invading the liver parencyma, common bile duct, hepatoduodenal ligament and transverse colon, which were resected "en bloc" with the tumor. The resected specimen weighted 2, 105 g, and the histological examination showed that most areas consisted of undifferentiated small cells. There were also focal areas showing epithelial connection of the tumor cells, where they stained for CA19-9 and cytokeratin. Because of the very poor prognosis of undifferentiated carcinoma of the gallbladder and its early remote lymphnode metastasis, early diagnosis and surgical treatment must be achieved.

Key words
undifferentiated carcinoma of the gallbladder, neuron-specific enolase

Reprint requests
Shinpei Matsuyama First Department of Surgery, Shinsyu University, School of Medicine
3-1-1 Asahi, Matsumoto, 390 JAPAN

Accepted
April 14, 1993

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