A Case of Endocrine Cell Carcinoma of the Gallbladder

Michinori Murayama, Keiichi Fujino, Hideki Kobayashi, Chiyuki Watanabe, Masaru Ishiyama, Yu Sakai*, Ryo Wada*, Noriyuki Kuwabara*

Department of Surgery and Pathology*, Japanese Self-Defense Forces Central Hospital

A 68-year-old woman complained of upper right abdominal pain during follow-up after radical resection of the ascending colon cancer 6 years ago. Imaging study reveaeld a thick wall of the gallbladder with irregular elevated lesions, anomalous arrangement of the pancreaticobiliary system and no gallstones. Abdominal ultrasonography showed a low echoic area in the liver bed and abdominal computed tomography showed a high density area with ataining in the same area. At the operation, dissemination, invasion to the serosa or subserosa or direct invasion to the liver bed was denied, and cholecystectomy and lymph node dissection was performed. Microscopic findings revealed multinodular undifferentiated carcinoma with well differentiated tubular adenocarcinoma in situ. Immunohistochemical study showed that the tumor was endocrine cell carcinoma. Carcinoma partially invaded to the serosa, but was not exposed on the surface of the liver bed. The imaging findings of the liver bed probably resulted from increased cystic venous drainage. The patient was died 3 months after surgery. Autopsy showed multiple metastases. We reported a case of endocrine cell carcinoma of the gallbladder that was thought to be relatively rare and the interesting findings of the image.

Key words
gallbladder cancer, endocrine cell carcinoma, anomalous arrangemnt of the pancreaticobiliary system

Reprint requests
Michinori Murayama Department of Surgery, Japanese Self-Defense Forces Central Hospital
1-2-24 Ikejiri Setagaya-ku, Tokyo, 154 JAPAN

Accepted
October 9, 1996

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