Squamous cell carcinoma of the gallbladder is rare and accounts for about 12.7% of all cases of gallbladder cancer. Pure squamous cell carcinoma is even less common with a reported incidence of 3.3%. We present a case...Squamous cell carcinoma of the gallbladder is rare and accounts for about 12.7% of all cases of gallbladder cancer. Pure squamous cell carcinoma is even less common with a reported incidence of 3.3%. We present a case of 72 year-old African-American woman with decreased appetite, fatigue, and weight loss associated with intermittent right upper quadrant pain for two months. Computed tomography of the abdomen revealed a mass in the gallbladder and the hepatic flexure of the colon with involvement of adjacent small bowel. On exploratory laparotomy, a mass at the dome of the gallbladder was found with local invasion of the hepatic flexure, and the proximal transverse colon. There was no obvious involvement of the duodenum, common bile duct, or the extra-hepatic biliary tree. An extended right hemicolectomy, distal small bowel resection, cholecystectomy, a wedge resection of the liver and a feeding jejunostomy, were performed. Pathologic evaluation demonstrated well to moderately differentiated squamous cell carcinoma of gallbladder without evidence of distant metastasis. The patient improved clinically and was discharged home in good condition.展开更多
Objective: To improve early diagnosis of primary gallbladder carcinoma (PGC) and the understanding of its pathogenesis, pathological stages and progno- sis. Methods: The data from 679 patients with PGC trea- ted in ou...Objective: To improve early diagnosis of primary gallbladder carcinoma (PGC) and the understanding of its pathogenesis, pathological stages and progno- sis. Methods: The data from 679 patients with PGC trea- ted in our hospital from 1956 to 1998 were analyzed retrospectively. Results: The incidence of PGC has been increasing in recent years, and the treatment is not satisfactory. Upon diagnosis, most patients with PGC were at ad- vanced stage. PGC was usually found in elderly women. The ratio of man to woman was 1:3. The gallstone, closely related to PGC, was found in 60% of the patients with PGC. The diagnostic accordance rate before and after operation was Iow. In most pa- tients, PGC was found unexpectedly during opera- tion for gallstone or acute cholecystitis. Many pa- tients with PGC missed the opportunity of diagnosis and therapy because doctor only noticed the diagnosis of gallstone. Pathological classification revealed that PGC in most patients (84.4%) were adenocarcino- ma. Imaging helped to find early-stage cases and im- prove prognosis. Conclusions: Understanding of pathogenesis, patho- logical stages and prognosis of PGC and proper use of various examinations are essential to the early di- agnosis and treatment of the disease.展开更多
BACKGROUND Synchronous primary cancers(SPCs) have become increasingly frequent over the past decade.However,the coexistence of duodenal papillary and gallbladder cancers is rare,and such cases have not been previously...BACKGROUND Synchronous primary cancers(SPCs) have become increasingly frequent over the past decade.However,the coexistence of duodenal papillary and gallbladder cancers is rare,and such cases have not been previously reported in the English literature.Here,we describe an SPC case with duodenal papilla and gallbladder cancers and its diagnosis and successful management.CASE SUMMARY A 68-year-old Chinese man was admitted to our hospital with the chief complaint of dyspepsia for the past month.Contrast-enhanced computed tomography of the abdomen performed at the local hospital revealed dilatation of the bile and pancreatic ducts and a space-occupying lesion in the duodenal papilla.Endoscopy revealed a tumor protruding from the duodenal papilla.Pathological findings for the biopsied tissue revealed tubular villous growth with moderate heterogeneous hyperplasia.Surgical treatment was selected.Macroscopic examination of this surgical specimen revealed a 2-cm papillary tumor and another tumor protruding by 0.5 cm in the gallbladder neck duct.Intraoperative rapid pathology identified adenocarcinoma in the gallbladder neck duct and tubular villous adenoma with high-grade intraepithelial neoplasia and local canceration in the duodenal papilla.After an uneventful postoperative recovery,the patient was discharged without complications.CONCLUSION It is essential for clinicians and pathologists to maintain a high degree of suspicion while evaluating such synchronous cancers.展开更多
背景与目的:原发性胆囊癌(primary carcinoma of the gallbladder,PCG)是死亡率极高的恶性肿瘤,其恶变的机制目前尚未明确。前期研究发现,p57^(KIP2)在人类多种恶性肿瘤中异常表达。本研究拟进一步探讨p57^(KIP2)在PCG组织中的表达及临...背景与目的:原发性胆囊癌(primary carcinoma of the gallbladder,PCG)是死亡率极高的恶性肿瘤,其恶变的机制目前尚未明确。前期研究发现,p57^(KIP2)在人类多种恶性肿瘤中异常表达。本研究拟进一步探讨p57^(KIP2)在PCG组织中的表达及临床意义。方法:运用实时荧光定量聚合酶链反应(real-time fluorescence quantitative polymerase chain reaction,RTFQ-PCR)、免疫组织化学EliVision法分别检测60例PCG、20例胆囊腺瘤(adenoma of the gallbladder,AG)和20例慢性胆囊炎(chronic cholecystitis,CC)组织中p57^(KIP2)、cyclin D1、cyclin E mRNA表达及蛋白水平。结果:p57^(KIP2) mRNA及蛋白在PCG、AG和CC中的表达逐渐升高,两两比较差异有统计学意义(P<0.05)。Cyclin D1、cyclin E mRNA及蛋白在PCG、AG和CC中的表达逐渐降低,PCG与AG比较、PCG与CC比较,差异有统计学意义(P<0.05)。在PCG组织中,p57^(KIP2)蛋白的表达与临床分期、组织学分级及淋巴结转移有关(P<0.05)。Cyclin D1蛋白的表达与临床分期有关(P<0.05)。p57^(KIP2)与cyclin D1的表达呈负相关(P<0.05),p57^(KIP2)与cyclin E的表达呈负相关(P<0.05),cyclin D1与cyclin E的表达呈正相关(P<0.05)。结论:p57^(KIP2)表达的降低与cyclin D1、cyclin E表达的增加可能是PCG的发生机制之一;检测p57^(KIP2)、cyclin D1及cyclin E对PCG的预后判断有重要意义。展开更多
文摘Squamous cell carcinoma of the gallbladder is rare and accounts for about 12.7% of all cases of gallbladder cancer. Pure squamous cell carcinoma is even less common with a reported incidence of 3.3%. We present a case of 72 year-old African-American woman with decreased appetite, fatigue, and weight loss associated with intermittent right upper quadrant pain for two months. Computed tomography of the abdomen revealed a mass in the gallbladder and the hepatic flexure of the colon with involvement of adjacent small bowel. On exploratory laparotomy, a mass at the dome of the gallbladder was found with local invasion of the hepatic flexure, and the proximal transverse colon. There was no obvious involvement of the duodenum, common bile duct, or the extra-hepatic biliary tree. An extended right hemicolectomy, distal small bowel resection, cholecystectomy, a wedge resection of the liver and a feeding jejunostomy, were performed. Pathologic evaluation demonstrated well to moderately differentiated squamous cell carcinoma of gallbladder without evidence of distant metastasis. The patient improved clinically and was discharged home in good condition.
文摘Objective: To improve early diagnosis of primary gallbladder carcinoma (PGC) and the understanding of its pathogenesis, pathological stages and progno- sis. Methods: The data from 679 patients with PGC trea- ted in our hospital from 1956 to 1998 were analyzed retrospectively. Results: The incidence of PGC has been increasing in recent years, and the treatment is not satisfactory. Upon diagnosis, most patients with PGC were at ad- vanced stage. PGC was usually found in elderly women. The ratio of man to woman was 1:3. The gallstone, closely related to PGC, was found in 60% of the patients with PGC. The diagnostic accordance rate before and after operation was Iow. In most pa- tients, PGC was found unexpectedly during opera- tion for gallstone or acute cholecystitis. Many pa- tients with PGC missed the opportunity of diagnosis and therapy because doctor only noticed the diagnosis of gallstone. Pathological classification revealed that PGC in most patients (84.4%) were adenocarcino- ma. Imaging helped to find early-stage cases and im- prove prognosis. Conclusions: Understanding of pathogenesis, patho- logical stages and prognosis of PGC and proper use of various examinations are essential to the early di- agnosis and treatment of the disease.
基金Supported by the Jiaxing Science and Technology Plan Project (Civil Science and Technology Innovation Project),No. 2019AY32028。
文摘BACKGROUND Synchronous primary cancers(SPCs) have become increasingly frequent over the past decade.However,the coexistence of duodenal papillary and gallbladder cancers is rare,and such cases have not been previously reported in the English literature.Here,we describe an SPC case with duodenal papilla and gallbladder cancers and its diagnosis and successful management.CASE SUMMARY A 68-year-old Chinese man was admitted to our hospital with the chief complaint of dyspepsia for the past month.Contrast-enhanced computed tomography of the abdomen performed at the local hospital revealed dilatation of the bile and pancreatic ducts and a space-occupying lesion in the duodenal papilla.Endoscopy revealed a tumor protruding from the duodenal papilla.Pathological findings for the biopsied tissue revealed tubular villous growth with moderate heterogeneous hyperplasia.Surgical treatment was selected.Macroscopic examination of this surgical specimen revealed a 2-cm papillary tumor and another tumor protruding by 0.5 cm in the gallbladder neck duct.Intraoperative rapid pathology identified adenocarcinoma in the gallbladder neck duct and tubular villous adenoma with high-grade intraepithelial neoplasia and local canceration in the duodenal papilla.After an uneventful postoperative recovery,the patient was discharged without complications.CONCLUSION It is essential for clinicians and pathologists to maintain a high degree of suspicion while evaluating such synchronous cancers.
文摘背景与目的:原发性胆囊癌(primary carcinoma of the gallbladder,PCG)是死亡率极高的恶性肿瘤,其恶变的机制目前尚未明确。前期研究发现,p57^(KIP2)在人类多种恶性肿瘤中异常表达。本研究拟进一步探讨p57^(KIP2)在PCG组织中的表达及临床意义。方法:运用实时荧光定量聚合酶链反应(real-time fluorescence quantitative polymerase chain reaction,RTFQ-PCR)、免疫组织化学EliVision法分别检测60例PCG、20例胆囊腺瘤(adenoma of the gallbladder,AG)和20例慢性胆囊炎(chronic cholecystitis,CC)组织中p57^(KIP2)、cyclin D1、cyclin E mRNA表达及蛋白水平。结果:p57^(KIP2) mRNA及蛋白在PCG、AG和CC中的表达逐渐升高,两两比较差异有统计学意义(P<0.05)。Cyclin D1、cyclin E mRNA及蛋白在PCG、AG和CC中的表达逐渐降低,PCG与AG比较、PCG与CC比较,差异有统计学意义(P<0.05)。在PCG组织中,p57^(KIP2)蛋白的表达与临床分期、组织学分级及淋巴结转移有关(P<0.05)。Cyclin D1蛋白的表达与临床分期有关(P<0.05)。p57^(KIP2)与cyclin D1的表达呈负相关(P<0.05),p57^(KIP2)与cyclin E的表达呈负相关(P<0.05),cyclin D1与cyclin E的表达呈正相关(P<0.05)。结论:p57^(KIP2)表达的降低与cyclin D1、cyclin E表达的增加可能是PCG的发生机制之一;检测p57^(KIP2)、cyclin D1及cyclin E对PCG的预后判断有重要意义。
