Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2019; 7(23): 4163-4171
Published online Dec 6, 2019. doi: 10.12998/wjcc.v7.i23.4163
Pure squamous cell carcinoma of the gallbladder locally invading the liver and abdominal cavity: A case report and review of the literature
Shan Jin, Lu Zhang, Yuan-Feng Wei, Hai-Jun Zhang, Cheng-Yan Wang, Hong Zou, Jian-Ming Hu, Jin-Fang Jiang, Li-Juan Pang
Shan Jin, Lu Zhang, Yuan-Feng Wei, Hai-Jun Zhang, Cheng-Yan Wang, Hong Zou, Jian-Ming Hu, Jin-Fang Jiang, Li-Juan Pang, Department of Pathology, the First Affiliated Hospital to Shihezi University School of Medicine and Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
Shan Jin, Lu Zhang, Yuan-Feng Wei, Hai-Jun Zhang, Cheng-Yan Wang, Hong Zou, Jian-Ming Hu, Jin-Fang Jiang, Li-Juan Pang, Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
Author contributions: Jin S and Zhang L were the patient’s pathologists, reviewed the literature, and contributed to manuscript drafting; Wei YF reviewed the literature and contributed to manuscript drafting; Zhang HJ and Wang CY performed the etiological analyses and interpretation and contributed to manuscript drafting; Zou H analyzed and interpreted the clinicopathological features; Hu JM and Jiang JF performed the molecular mechanism consultation, reviewed the literature, and drafted the manuscript; Pang LJ was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Supported by the National Natural Science Foundation of China, No. 81560053; the Youth Science and Technology Innovation Leading Talents Project of Corps, No. 2017CB004; International Science and Technology Cooperation Promotion Plan of Shihezi University, No. GJHZ201805; Xinjiang Production and Construction Corps Key Areas Innovation Team Project, No. 2018CB002.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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: Li-Juan Pang, MD, PhD, Chief Physician, Professor, Department of Pathology, Shihezi University School of Medicine and the First Affiliated Hospital to Shihezi University School of Medicine, North 2nd Road, Shihezi 832002, Xinjiang Uygur Autonomous Region, China. ocean123456@163.com
Telephone: +86-993-2850955 Fax: +86-993-2015620
Received: June 19, 2019
Peer-review started: June 26, 2019
First decision: September 9, 2019
Revised: September 30, 2019
Accepted: October 15, 2019
Article in press: October 15, 2019
Published online: December 6, 2019
Processing time: 170 Days and 21.3 Hours
Abstract
BACKGROUND

Gallbladder squamous cell carcinoma (GBSCC) is a rare subtype of malignancy and accounts for only 2%-3% of gallbladder malignancies. Due to its rapid development, most patients with GBSCC initially present with an advanced stage of the disease and hence a poor prognosis. The clinicopathological and biological features of SCC remain to be fully elucidated, owing to its uncommon occurrence. The majority of currently available data only described individual case reports or series analyses of trivial cases.

CASE SUMMARY

A 64-year-old man was admitted for progressively poor abdominal distension and pain. Liver computed tomography (CT) showed infiltration of gallbladder carcinoma into the adjacent liver, and enlarged retroperitoneal lymph nodes. The patient underwent radical cholecystectomy. Part of the mass was grey and soft, and the neoplastic section showed a purulent-necrotic lesion. Hematoxylin and eosin staining revealed a moderately differentiated SCC. Immunohistochemical studies showed strong staining of the tumor for AE1/3 and CK5/6. Staining for CK19, CK7, and CAM5.2 was positive in the cytoplasm. Systemic chemotherapy was not administered because of the patient’s poor physical condition. After five months, CT and magnetic resonance cholangiopancreatography showed multiple metastases in the liver and abdominal cavity.

CONCLUSION

Squamous components of GBSCC may explain the complex biological behavior, and CD109 may be involved in the pathogenesis.

Keywords: Gallbladder; Squamous cell carcinoma; Squamous metaplasia; Cholecystectomy; Case report

Core tip: Squamous cell carcinoma of gallbladder (GBSCC) is a rare subtype, and it has a poor prognosis. The squamous components that may explain the complex biological behavior and its poor prognosis show greater capacities of proliferation and local invasive in gallbladder carcinoma. Surgical resection has been considered as the basis of treatment for years, and complete resection is associated with increased survival. CD109 may be involved in the pathogenesis of GBSCC and serves as a novel target for intervention.