Cribriform carcinoma of the gallbladder: a clinicopathologic study of 7 cases

Carcinomas of the gallbladder are morphologically heterogeneous. Some are similar or mimic carcinomas that commonly arise in other organs and therefore can be confused with metastatic lesions. We report here the clinicopathologic features of 7 cribriform carcinomas of the gallbladder that resemble cribriform carcinomas of the breast. Five patients were women and 2 men whose ages ranged from 31 to 72 years (average age 57 y). These 7 patients were younger than those with conventional adenocarcinomas of the gallbladder (average age for males 71 y and average age for females 72 y). Five patients had cholelithiasis. The youngest patient, a 31-year-old woman, had no gallstones. Instead, she had an osteosarcoma removed from her distal femur, 4 years before. Although the osteosarcoma in this patient may be coincidental, a true association could not be entirely excluded. None of the 4 cribriform carcinomas of the gallbladder tested showed immunoreactivity for estrogen and progesterone receptors. Three patients with high nuclear grade cribriform carcinomas died as a result of the tumor which infiltrated the liver by direct extension; 3 patients with low nuclear grade cribriform carcinomas confined to the gallbladder wall survived 4 to 7 years after cholecystectomy and 1 patient was lost to follow-up. In conclusion, this study provides support to previous observations that a small proportion of gallbladder carcinomas display an unusual but predominant cribriform pattern similar to that of some invasive breast carcinomas. In contrast to mammary cribriform carcinomas, those arising in the gallbladder occur in individuals usually with gallstones, may coexist with skeletal osteosarcoma, lack estrogen and progesterone receptors, and behave aggressively like conventional adenocarcinomas of the gallbladder.