title: A case report of the clear cell variant of gallbladder carcinoma.
abstract: BACKGROUND
  Clear cell gallbladder carcinoma accounts for less than 1% of all gallbladder malignancies and demonstrates its unique histopathological characteristics in patients with no prior medical illness or familial predisposition.
  
  
  METHODS
  Here we present a case of a 56-year-old female, with no prior medical conditions presented with a 2-month history of upper abdominal pain. Routine hematological and biochemical tests were unremarkable. An abdominal ultrasound revealed the presence of a gallbladder calculi, and a fundic mass while magnetic resonance cholangiopancreatography revealed a 8.0cm×3.5cm gallbladder mass. Computed tomography imaging excluded any distant haematogenous metastases. An open cholecystectomy with lymphadenectomy was proceeded by staging laparoscopy. Upon pathologic investigation, the morphologic and immunophenotypic features supported a diagnosis of clear cell variant of gallbladder carcinoma.
  
  
  CONCLUSIONS
  Pathological prognostications for primary clear cell gall bladder carcinomas are not well defined due to the rarity of cases and possible misidentification as secondary metastases. Foci of adenocarcinoma within the tumor along with immunohistochemical staining probes can be informative in consideration of differential diagnosis.
  
  
  CONCLUSIONS
  In these cases, clinical case management should be personalized for increased survival with the possible incorporation of next generation sequencing approaches to guide therapeutic algorithms. We discuss this exceedingly rare case of the clear cell variant of gallbladder carcinoma in detail, highlighting some of the diagnostic, and clinical challenges.
authors.affiliation: Department of Clinical Surgical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago. Electronic address: drravimaharajuwi@gmail.com.
authors.forename: Ravi
authors.initials: R
authors.lastname: Maharaj
authors.affiliation: Department of Clinical Surgical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago. Electronic address: starcj@hotmail.com.
authors.forename: Christo
authors.initials: C
authors.lastname: Cave
authors.affiliation: Department of Clinical Surgical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago. Electronic address: kevinsarran1@yahoo.com.
authors.forename: Kevin
authors.initials: K
authors.lastname: Sarran
authors.affiliation: Department of Clinical Surgical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago. Electronic address: nigelantonio@hotmail.com.
authors.forename: Nigel
authors.initials: N
authors.lastname: Bascombe
authors.affiliation: Department of Clinical Surgical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago. Electronic address: dilipdan5@gmail.com.
authors.forename: Dilip
authors.initials: D
authors.lastname: Dan
authors.affiliation: Department of Clinical Surgical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago. Electronic address: wesgreavesmd@gmail.com.
authors.forename: Wesley
authors.initials: W
authors.lastname: Greaves
authors.affiliation: Division of Oncology, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO 63110, USA. Electronic address: wayne.warner@wustl.edu.
authors.forename: Wayne A
authors.initials: WA
authors.lastname: Warner
keywords: Case report; Clear cell carcinoma; Gallbladder carcinoma; Neoplasm