Primary undifferentiated spindle-cell carcinoma of the gallbladder presenting as a liver tumor.
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.
Akatsu
Tomotaka
T
Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Ueda
Masakazu
M
Shimazu
Motohide
M
Wakabayashi
Go
G
Aiura
Koichi
K
Tanabe
Minoru
M
Kawachi
Shigeyuki
S
Kameyama
Kaori
K
Kitajima
Masaki
M
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