Gallbladder small cell carcinoma: a case report and literature review.
Gallbladder small cell carcinoma: a case report and literature review.
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DOI：
10.1186/s40792-016-0200-3
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发表时间：
2016-12
影响因子：
0.8
通讯作者：
Eguchi S
中科院分区：
文献类型：
--
作者：
Adachi T;Haraguchi M;Irie J;Yoshimoto T;Uehara R;Ito S;Tokai H;Noda K;Tada N;Hirabaru M;Inoue K;Minami S;Eguchi S
胆囊小细胞癌（SCC）仅占所有胆囊癌的0.5%，并且由侵袭性肿瘤组成，与目前的治疗相比生存结局较差。这些肿瘤最常见于老年女性，尤其是胆囊结石患者。我们报告了一名79岁女性胆囊小细胞癌的病例。患者出现间歇性右上腹疼痛，因疑似急性胆囊炎入院。她定期接受糖尿病、高血压和血脂异常的药物治疗。在初始实验室评估时，天冬氨酸氨基转移酶（AST）、总胆红素和C反应蛋白（CRP）水平显著升高。她接受了计算机断层扫描（CT）筛查。CT图像显示厚壁胆囊，包含多个结石和多个3 cm大小的圆形结节性病变，这些病变提示淋巴结转移。在经皮胆囊穿刺引流后，内镜超声引导下细针穿刺肿大淋巴结，诊断为小细胞癌或腺癌。然而，由于没有决定性因素，我们无法在手术前确定原发病变。我们进行胆囊切除术，因为有可能胆囊炎复发的风险，也部分肝切除术，因为我们怀疑肿瘤浸润。最后病理诊断为胆囊神经内分泌癌，小细胞型。肿瘤分期为IVb、T3aN1M1。患者在手术后13周死亡。在本文中，我们回顾了目前可用的英文文献胆囊SCC。
Gallbladder small cell carcinoma (SCC) comprises only 0.5 % of all gallbladder cancer and consists of aggressive tumors with poor survival outcomes against current treatments. These tumors are most common in elderly females, particularly those with cholecystolithiasis. We report the case of a 79-year-old woman with gallbladder small cell carcinoma. The patient had intermittent right upper quadrant abdominal pain and was admitted to our hospital due to suspected acute cholecystitis. She regularly received medical treatment for diabetes, hypertension, and dyslipidemia. On initial laboratory evaluation, the levels of aspartate aminotransferase (AST), total bilirubin, and C-reactive protein (CRP) were markedly elevated. She underwent computed tomography (CT) for screening. CT images showed a thick-walled gallbladder containing multiple stones and multiple 3-cm-sized round nodular lesions, which were suggestive of metastatic lymph nodes. After percutaneous transhepatic gallbladder drainage was performed, endoscopic ultrasound-guided fine needle aspiration of enlarged lymph nodes resulted in a diagnosis of small cell carcinoma or adenocarcinoma. However, we could not identify the primary lesion before the surgery because of no decisive factors. We performed cholecystectomy because there was a possibility of cholecystitis recurrence risk and also partial liver resection because we suspected tumor invasion. The final pathological diagnosis was neuroendocrine carcinoma of the gallbladder, small cell type. The tumor stage was IVb, T3aN1M1. The patient died 13 weeks after the surgery. In the present paper, we review the current available English-language literature of gallbladder SCC.