Incidental T1a Gallbladder Cancer with Signet Ring Cell Carcinoma Following Laparoscopic Cholecystectomy: A Case Report.

IF 0.7 Q4 SURGERY
Surgical Case Reports Pub Date : 2025-01-01 Epub Date: 2025-02-14 DOI:10.70352/scrj.cr.24-0078
Yoshihito Kitamura, Masakazu Hashimoto, Ryo Nagao, Makoto Shinohara, Keigo Nakashima, Yui Hattori, Michinori Hamaoka, Masashi Miguchi, Toshihiro Misumi, Nobuaki Fujikuni, Satoshi Ikeda, Yasuhiro Matsugu, Takashi Nishisaka, Hideki Nakahara
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Abstract

Introduction: Signet ring cell carcinoma (SRC) of the gallbladder is a rare type of gallbladder cancer. We report a case of SRC of the gallbladder that was characterized by the diffuse presence of SRC on the gallbladder mucosa and diagnosed after cholecystectomy.

Case presentation: A 40-year-old man was referred to our department with upper abdominal pain and vomiting. Based on the findings of blood tests, computed tomography, and magnetic resonance imaging, acute cholecystitis was suspected, and emergency laparoscopic cholecystectomy was performed. Intraoperative findings showed mild inflammation. Although the tumor remained within the mucosa, tumor cell infiltration was suspected at the edge of cystic duct pathologically. Although additional endoscopic ultrasound and endoscopic retrograde cholangiography showed that horizontal extension into the residual cholecystic duct was suspected, there was no evidence of invasion into the common bile duct, lymph node metastasis, or distant metastasis. One and a half months after cholecystectomy, the patient underwent extrahepatic bile duct resection, lymph node dissection, and bile duct jejunal anastomosis. The postoperative course was uneventful, and the patient was discharged on the 10th postoperative day. Postoperative pathological analysis showed no obvious residual tumor tissue in the common bile duct or choledochal duct margins, and no metastasis in the submitted lymph nodes. Based on the above, a diagnosis of pT1aN0M0, pStage IA SRC was made. As no lymph node metastasis was observed, it was decided to follow up the patient without initiating postoperative chemotherapy, and the patient has been recurrence-free for 12 months after surgery.

Conclusions: We describe an incidentally discovered case of intramucosal SRC diffusely spreading throughout the gallbladder after cholecystectomy for acute cholecystitis.

腹腔镜胆囊切除术后偶发T1a胆囊癌合并印戒细胞癌1例。
胆囊印戒细胞癌(SRC)是一种罕见的胆囊癌。我们报告一个胆囊SRC的病例,其特征是在胆囊粘膜上弥漫性存在SRC,并在胆囊切除术后诊断。病例介绍:一名四十岁男性因上腹部疼痛及呕吐而转介至我科。根据血液检查,计算机断层扫描和磁共振成像的结果,怀疑急性胆囊炎,并进行了紧急腹腔镜胆囊切除术。术中表现为轻度炎症。虽然肿瘤仍在粘膜内,但病理上怀疑肿瘤细胞浸润于囊管边缘。虽然附加的内镜超声和内镜逆行胆管造影显示怀疑其水平延伸至残余胆管,但未发现侵犯总胆管、淋巴结转移或远处转移的证据。胆囊切除术后1个半月,行肝外胆管切除术、淋巴结清扫、胆管空肠吻合术。术后过程顺利,患者于术后第10天出院。术后病理分析显示胆总管及胆总管边缘未见明显肿瘤组织残留,提交淋巴结未见转移。基于以上,我们诊断为pT1aN0M0, pStage IA SRC。由于未见淋巴结转移,故决定随访,术后不进行化疗,患者术后12个月无复发。结论:我们描述了一例偶然发现的粘膜内SRC在急性胆囊炎胆囊切除术后弥漫性扩散到整个胆囊。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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审稿时长
13 weeks
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