En bloc total biliary resection hepatectomy for the treatment of gallbladder adenosquamous carcinoma: a case report

ABSTRACT

Introduction: Gallbladder cancer is a rare type of biliary tract malignancy with poorly defined pathogenesis, difficult treatment and often inoperable.

Case Report: A 84-year-old male presented with pain in the right hypochondrium with three months of progressive worsening. Ultrasound routine examination showed the presence of a large mass in the gallbladder adjacent topography that also showed signs of invasion in the liver tissue. He was submitted to preoperative staging with chest and abdomen MRI with intravenous contrast. A resection of the IVB, V and VI hepatic segments was performed associated to complete resection of the extra hepatic bile duct en bloc. Main bile duct reconstruction with Y-Roux jejunostomy was also performed.

Discussion: Gallbladder carcinoma with squamous component is a rare type of cancer with poor prognosis whose treatment with a curative potential is only possible with surgery, in case the lesion is resectable.

RESUMO

Introdução: O câncer da vesícula biliar é um tipo raro de malignidade do trato biliar com patogênese mal definida, tratamento difícil e muitas vezes inoperável.

Relato de Caso: Um homem de 84 anos apresentou-se com dor em hipocôndrio direito com três meses de piora progressiva. O exame ultrassonográfico de rotina mostrou a presença de uma grande massa na topografia adjacente à vesícula biliar que também apresentava sinais de invasão no tecido hepático. Foi submetido ao estadiamento pré-operatório com RM de tórax e abdome com contraste endovenoso. Foi realizada ressecção dos segmentos hepáticos IVB, V e VI associada à ressecção completa do ducto biliar extrahepático em bloco. Também foi realizada a reconstrução do ducto biliar principal com jejunostomia em Y-Roux.

Discussão: O carcinoma com componente escamoso da vesícula biliar é um tipo de câncer raro e de mau prognóstico, cujo tratamento com potencial curativo só é possível com cirurgia, caso a lesão seja ressecável.

Headings:

Gallbladder neoplasms - Gallbladder diseases - Hepatectomy

Descritores:

Neoplasias da vesícula biliar - Doenças da vesícula biliar - Hepatectomia

Conflict of Interests

There is no conflict of interest.

Publication History

Received: 20 April 2021

Accepted: 26 November 2021

Article published online:
22 February 2022

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