Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2019; 7(18): 2787-2793
Published online Sep 26, 2019. doi: 10.12998/wjcc.v7.i18.2787
Giant squamous cell carcinoma of the gallbladder: A case report
Marcelo AF Ribeiro Junior, Murillo de Lima Favaro, Stephanie Santin, Cintia Magalhães Silva, Ana Paula Marconi Iamarino
Marcelo AF Ribeiro Junior, Department of Acute Care and Trauma Surgery, Hospital Moriah, São Paulo 04081000, Brazil
Murillo de Lima Favaro, Department of Surgery, University of Santo Amaro, São Paulo 04829-300, Brazil
Stephanie Santin, Department of Surgery, Hospital Moriah, University of Santo Amaro, São Paulo 04829-300, Brazil
Cintia Magalhães Silva, Medical Student, University of Santo Amaro, São Paulo 04829-300, Brazil
Ana Paula Marconi Iamarino, Department of Surgery, Hospital Moriah, Hospital Moriah, São Paulo 04829-300, Brazil
Author contributions: Ribeiro Junior MAF and Favaro ML contributed equally to this work; Ribeiro Junior MAF designed the research; Iamarino APM, Silva CM and Santin S performed the research; Ribeiro Junior MAF and Favaro ML analyzed the data; and Ribeiro Junior MAF, Silva CM and Iamarino APM wrote the paper.
Informed consent statement: Written informed consent was obtained from the patient for publication of this manuscript and any accompanying images.
Conflict-of-interest statement: None of authors have any kind of conflict of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Marcelo AF Ribeiro Junior, MD, MSc, PhD, Chairman, Full Professor, Department of Acute Care and Trauma Surgery, Hospital Moriah, Avenida Aratas, 200, São Paulo 04081000, Brazil. drmribeiro@gmail.com
Telephone: +55-11-968439911
Received: April 2, 2019
Peer-review started: April 4, 2019
First decision: August 1, 2019
Revised: August 17, 2019
Accepted: August 27, 2019
Article in press: August 26, 2019
Published online: September 26, 2019
Processing time: 175 Days and 18.4 Hours
Abstract
BACKGROUND

Gallbladder cancer is the most common malignant tumor of the biliary tract. The majority of cases are adenocarcinoma. Squamous cell carcinoma is the histological type present in 12% of all neoplasias accounting for approximately 12% of gallbladder neoplasms. It can occur in its pure form reaching 1%-3% of the tumors. Many patients are at an advanced stage when diagnosed and have bad therapeutic efficacy.

CASE SUMMARY

A 45-year-old male patient presented with left flank pain for 1 year and irradiated to the mesogastric region. He denied fever, vomiting, and any other intestinal changes. He reported a weight loss of 10 kg in a period of 7 mo. He denied alcoholism, smoking, drug use, or prior illness. Computed tomography of the abdomen showed in the gallbladder fossa a voluminous mesogastric heterogeneous collection that had a thick and irregular capsule with liquid and gaseous contents. A predominantly hypoattenuating rounded material with partially calcified margins measuring about 2.0 cm related to gallstone was also emphasized. No lymphadenomegalies or free fluid was observed in the abdominal cavity. Patient underwent laparotomy where a huge tumor was observed affecting the transverse colon and gallbladder. This mass was resected en bloc removing gallbladder and transverse colon together with corresponding mesocolon and regional lymphadenectomy. There were no complications in the postoperative period. Although oncological treatment was performed, the patient died 6 mo after surgery.

CONCLUSION

Squamous cell carcinoma represents a rare disease. Patients often present with large, bulky tumors with involvement of adjacent organs. In spite of progress in surgical techniques and adjuvant chemotherapy, the prognosis remains poor.

Keywords: Squamous cell; Carcinoma; Gallbladder neoplasm; Treatment; Case report

Core tip: Pure squamous cell carcinoma represents a very rare condition. Usually the patient will present with a huge mass in the upper right quadrant involving other organs. A high index of suspicion is fundamental for the surgical planning because the surgical removal of the lesion respecting the oncological surgical principles may be the only chance of cure for this aggressive disease. Patients must be submitted to adjuvant chemotherapy in order to increase the survival rates. The prognosis remains poor.