title: Primary undifferentiated spindle-cell carcinoma of the gallbladder presenting as a liver tumor.
abstract: Undifferentiated spindle-cell carcinoma (SpCC) of the gallbladder is extremely rare. There is very little information available regarding the characteristics and treatment of this disease. We herein report the unique case of a 76-year-old female patient with a primary SpCC of the gallbladder that presented as a liver tumor. Preoperative radiologic examinations showed a 5-cm liver tumor around the gallbladder bed, and irregular thickening of the gallbladder wall. The patient underwent en-bloc resection of the gallbladder and segments 4b and 5 of the liver (including the liver tumor). Microscopic findings revealed that both lesions consisted mainly of a sarcomatous spindle-shaped component. Small foci of well-differentiated adenocarcinoma cells were identified in the gallbladder mucosa. There was a gradual transition between the two different components, thereby implying that these two cell types had a common origin. Immunohistochemical studies showed that the spindle-shaped cells were epithelial in nature. The patient's postoperative course was uneventful. However, she died of recurrent liver disease 6 months after the surgery. In conclusion, we surmised that the sarcomatous spindle cells originated from a carcinomatous component in the gallbladder mucosa through dedifferentiation. Further studies are needed to better understand the characteristics of this deadly tumor, and to establish an effective therapy for it.
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Akatsu
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ueda
authors.forename: Motohide
authors.initials: M
authors.lastname: Shimazu
authors.forename: Go
authors.initials: G
authors.lastname: Wakabayashi
authors.forename: Koichi
authors.initials: K
authors.lastname: Aiura
authors.forename: Minoru
authors.initials: M
authors.lastname: Tanabe
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kawachi
authors.forename: Kaori
authors.initials: K
authors.lastname: Kameyama
authors.forename: Masaki
authors.initials: M
authors.lastname: Kitajima
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D002277:Carcinoma / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D009361:Neoplasm Invasiveness