A Case of Adenoendocrine Cell Carcinoma of the Gallbladder with Squamous Differentiation in Metastatic Lymph Node

Mitsuo Mori, Teiko Sato¹⁾, Kentarou Yamamoto, Hiroaki Seki, Hiroki Ishikawa and Yutaka Tsutsumi²⁾

Department of Surgery and Department of Pathology¹⁾, Keiyu Hospital
Department of Pathology, Fujita Health University School of Medicine²⁾

We report an extremely rare case of combined adenoendocrine cell tumor of the gallbladder and a metastatic lymph node with squamous cell differentiation. A 70-year-old woman reporting epigastric pain and referred for investigation of a tumor in the gallbladder was found in abdominal ultrasonography to have a soft tissue mass 36× 15 mm protruding intraluminally at the fundus of the gallbladder. Abdominal computed tomography (CT) showed a polypoid lesion at the fundus of the gallbladder, with diffuse wall thickening. Swelling of a lymph node at the superior retropancreatic region was detected. No findings indicated tumor invasion to the liver parenchyma at the gallbladder bed. The patient was diagnosed with gallbladder carcinoma, and underwent cholecystectomy with wedge resection of the liver of the gallbladder bed and dissection of regional lymph nodes (D2). Pathologically, the polypoid tumor at the fundus was endocrine cell carcinoma surrounded by granular-shaped well-differentiated adenocarcinoma in situ. Continuing this area at the neck portion of the gallbladder, there was 13× 12 mm-sized moderately differentiated tubular adenocarcinoma, which extends into subserosal layer. In the enlarged lymph node, metastatic carcinoma cells represented squamous differentiation. She died of cancer 32 months after surgery. The literature shows only 1 case report of endocrine cell carcinoma of the gallbladder mixed with adenocarcinoma and squamous cell carcinoma.

Key words
adenoendocrine cell carcinoma of the gallbladder, squamous cell carcinoma

Reprint requests
Mitsuo Mori Department of Surgery, Keiyu Hospital
3-7-3 Minatomirai, Nishi-ku, Yokohama, 220-8521 JAPAN

Accepted
July 28, 2004

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