A Case of Adenosquamous Carcinoma of the Gallbladder with Anomalous Arrangement of the Pancreaticobiliary Ductal System

Atsushi Adachi, Toshiaki Toshimitsu, Toshihiro Saeki, Tetsuji Uchiyama, Takuo Murakami

Department of Surgeruy, Iwakuni Medical Center Hospital

We report a case of resected adenosquamous carcinoma of the gallbladder with anomalous arrangement of the pancreaticobiliary ductal system. A 67-year-old woman was admitted to the hospital because of a tumor of the gallbladder, and liver dysfunction. Projecting of the tumor into the gallballer was observed by ultrasonography, and computed tomography, and an anomalous arrangement of the pancreaticobiliary ductal system with dilatation of the biliary tract was observed by ERCP. A cytologic diagnosis of adenosquamous carcinoma was obtained from the bile of the gallbladder and the biliary tract. So cholecystetomy with wedge resection of the liver, resection of the extrahepatic common bile duct, lymphadenectomy, and hepatico-jejunostomy were performed. The tumor presented macroscopically as a nodular infiltrating type. Microscopically it showed a mixed type of adenocarcinoma and squamous cell carcinoma with a transitional zone, suggesting that the adenosquamous carcinoma originated from adenocarcinoma. And metastatic lymphnode revealed mainly squamolus carcinoma, leading to a poor prognosis. The high level of amylase in the bile may be one of the factors leading to carcinoma in the gallbladder and the biliary tract.

Key words
adenosquamous carcinoma, anomalous arrangement of the pancreaticobiliary ductal system, gallbladder cancer

Reprint requests
Atsushi Adachi Department of Surgery, Iwakuni Medical Center Hospital
3-6-12 Muronoki, Iwakuni, 740-0021 JAPAN

Accepted
April 22, 1998

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