A Case of Signet Ring Cell Carcinoma of the Gallbladder

Takehiro Maki, Takashi Hara, Satoshi Hirano, Eiichi Tanaka, Katsunori Saitou, Motoya Takeuchi, Toshiaki Shichinohe, Kousaku Sato*, Hisao Mishina* and Satoshi Kondo

Department of Surgical Oncology, Hokkaido University
Cardio-vascular Center, Hokkaido Ohno Hospital*

We experienced a case of signet ring cell carcinoma of the gallbladder which is rare as primary tumor of the gallbladder. The patient was a 70-year-old male. He had an operation of laparoscopic cholecystectomy with the diagnosis of cholecystolithiasis at the Hokkaido Ohno Hospital. A slightly elevated (IIa) whitish lesion (8×7 mm) was detected on the mucosal surface of the abdominal side of the resected gallbladder body. Pathological diagnosis was signet ring cell carcinoma, slightly infiltrating into subserosa, and no other histological structure of malignant cells were detected. Lymphatic or venous infiltration was not detected. He was admitted to Surgical Oncology Hokkaido University for the treatment. CT denied residual cancer or lymphatic metastasis, but we decided to add operation. The operation method was cuneiform resection of the liver bed, and resection of the bile duct and D2 lymph node. He had no postoperative complication and the pathological examination indicated no residual malignant cell. He is alive without recurrence 34 months after the operation. Signet ring cells of the gallbladder tend to coexist with other histological forms of malignant cells, but in this case the signet ring cells were purely by themselves. And the size of the tumor was smallest of all the cases as far as we searched. This unique case indicates that signet ring cell carcinoma can generate de novo in the gallbladder as well as in the stomach.

Key words
gallbladder carcinoma, signet ring cell

Reprint requests
Takehiro Maki Kiyota Hospital
1-1-1-1 Shinei, Kiyota, Sapporo, 004-0831 JAPAN

Accepted
April 25, 2007

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