A Case Report of Advanced Gallbladder Carcinoma with Paraaortic Lymph Node Metastasis with 3 Years Recurrence Free Survival after Surgery

Yasuharu Tokuyama, Yasuhiro Shimizu and Kenzo Yasui

Department of Gastroenterological Surgery, Aichi Cancer Center

A 50-year-old woman with abdominal pain and a suspected biliary disorder was found in enhanced abdominal CT to have a nodular tumor 3 cm in diameter in the body of the gallbladder, swollen lymph nodes in the hepatoduodenal ligament that were suspected to have invaded the head of the pancreas, paraaortic lymph nodes (No. 16b1) swollen to 1 cm in diameter, and the right hepatic artery compressed by a swollen lymph node at the hepatic hilum. ERCP showed pancreaticobiliary maljunction without dilation of the common bile duct, a filling defect in the gallbladder, and a compressed common bile duct, leading to a diagnosis of advanced gallbladder carcinoma with paraaortic lymph node metastasis and necessitating right hepatic lobectomy and pancreaticoduodenectomy with regional and paraaortic lymphadenectomy. Histologically, the cancer was papillary adenocarcinoma with a depth of ss, lymph node Nos. 8p, 12b, 12p, 14, and 16b1 was positive and stage IVa. A pancreatic fistula was identified postoperatively. The woman was discharged on postoperative day 49, and is doing well without any sign of recurrence 3 years and 7 months later.

Key words
gall bladder carcinoma, paraaortic lymph node metastasis, 3-year survival without recurrence

Reprint requests
Yasuharu Tokuyama Department of Gastroenterological Surgery, Aichi Cancer Center
1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681 JAPAN

Accepted
January 26, 2005

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