Case Report: Moderately Differentiated Ulcerated Gallbladder Squamous Cell Carcinoma

Abstract

Objectives: To enrich the scant scientific evidence existing on this subject. Rationale: Because of this rarity of information, works like this one are indispensable for the scientific, academic and professional community by dealing with an uncommon theme with unique features. Methodology: This study was done with access to the BIREME database, as well as reviewing the patient’s chart. Case description: woman, 71 years old, morbidly obese with of BMI 42, complaining of pain in the right hypochondrium for ten days, positive Murphy’s sign, but without peritonitis markings. An ultrasonography of the abdomen showed gallstones with wall thickening suggestive of neoplasia. Underwent surgery after clearing the infection. During surgery, discovered the gallbladder was covered by omentum, blocked by the transverse colon and duodenum. Having cleared the adhesions, performed cholecystectomy segmentectomy and the anterior portion of segments IV and V after confirmation of malignancy freezing. The histopathological (HE and immunohistochemistry) of the surgical specimen pointed to ulcerated carcinoma moderately differentiated squamous cells. Discussion: squamous cell carcinomas are rare, thus creating sparse and sometimes diversive literature. Usually diagnosed in advanced stages as in the early stages it is considered to be a silent disease. The patient had typical clinical cholecystitis without evidence of weight loss or palpable bladder, in agreement with the literature, in which case most diagnoses are intraoperative, because of the similarity of the clinical picture. The biological behavior of squamous cell cancer is characterized by rapid growth, early metastatic spread and features local and regional infiltration, which also happened to the patient, described being found intraoperatively covered by omentum gallbladder, blocked by the transverse colon and duodenum, beyond the liver involvement, after confirmation by freezing. Although the patient in question had increased GGT present in their examinations, the involvement of the biliary tract was not evident. Conclusion: The reported case and cited publications lead to the conclusion that its being a rare histological type, and thus without extensive literature, a lot of data such as the actual outcome of these patients and the survival time are underestimated and difficult to locate meaningful data.