摘要
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 li ver tumor. Preoperative radiologic examinations showed a 5-cm liver tumor aroun d the gallbladder bed, and irregular thickening of the gallbladderwall. The pati ent underwent en-bloc resection of the gallbladder and segments 4b and 5 of the liver (including the liver tumor). Microscopic findings revealed that both lesi ons consisted mainly of a sarcomatous spindle-shaped component. Small foci of w ell-differentiated adenocarcinoma cells were identified in the gallbladder muco sa. There was a gradual transition between the two different components, thereby implying that these two cell types had a common origin. Immunohistochemical stu dies showed that the spindle-shaped cells were epithelial in nature. The patien t‘s postoperative course was uneventful. However, she died of recurrent liver d isease 6 months after the surgery. In conclusion, we surmised that the sarcomato us spindle cells originated from a carcinomatous component in the gallbladder mu cosa through dedifferentiation. Further studies are needed to better understand the characteristics of this deadly tumor, and to establish an effective therapy for it.
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 li ver tumor. Preoperative radiologic examinations showed a 5-cm liver tumor aroun d the gallbladder bed, and irregular thickening of the gallbladderwall. The pati ent underwent en-bloc resection of the gallbladder and segments 4b and 5 of the liver (including the liver tumor). Microscopic findings revealed that both lesi ons consisted mainly of a sarcomatous spindle-shaped component. Small foci of w ell-differentiated adenocarcinoma cells were identified in the gallbladder muco sa. There was a gradual transition between the two different components, thereby implying that these two cell types had a common origin. Immunohistochemical stu dies showed that the spindle-shaped cells were epithelial in nature. The patien t‘s postoperative course was uneventful. However, she died of recurrent liver d isease 6 months after the surgery. In conclusion, we surmised that the sarcomato us spindle cells originated from a carcinomatous component in the gallbladder mu cosa through dedifferentiation. Further studies are needed to better understand the characteristics of this deadly tumor, and to establish an effective therapy for it.
