Gallbladder adenosquamous cell carcinoma: report of two cases

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pathology

Background:

• Gallbladder carcinoma is rare, with adenocarcinoma being the usual type.
• Adenosquamous cell carcinoma (ASC) of the gallbladder is exceptionally rare, accounting for <3.5% of cases.
• ASC is characterized by invasive growth, reduced lymph node metastasis, and increased hepatic infiltration/metastasis, leading to a poorer prognosis than adenocarcinoma.

Observation:

• Two cases of gallbladder ASC are presented.
• Case 1: Patient with elevated bilirubin and dilated bile ducts, diagnosed with ASC post-surgery. Developed chemotherapy-resistant liver metastases.
• Case 2: Patient with jaundice and abdominal pain, CT showed gallbladder mass with liver extension. Diagnosed with malignant epithelial tumor via ERCP. Incompletely resected, developed biliary occlusion during chemotherapy.

Findings:

• Adenosquamous cell carcinoma of the gallbladder exhibits aggressive behavior with a propensity for liver metastasis.
• The presented cases illustrate the challenges in managing gallbladder ASC, including treatment resistance and post-surgical complications.
• Despite surgical intervention and chemotherapy, outcomes were poor, underscoring the advanced nature of the disease at presentation.

Implications:

• These cases highlight the need for early detection and aggressive management strategies for gallbladder adenosquamous cell carcinoma.
• Further research into novel therapeutic approaches is warranted for this aggressive subtype of gallbladder cancer.
• Understanding the distinct metastatic patterns of ASC is crucial for accurate staging and treatment planning.