Abstract

Primary pure squamous cell carcinoma (SCC) of the gallbladder is an exceptionally rare type of tumor that comprises only 1% of all gallbladder cancer. SCC of the gallbladder portends a worse prognosis than the more common adenocarcinoma variant because of its aggressive invasion to local structures and because it is often diagnosed at an advanced stage. Owing to its rarity, diagnosis and management can be challenging. Herein, we present the case of a 75-year-old female complaining of abdominal pain, nausea, and vomiting. Computed tomography and ultrasonography results of the abdomen were consistent with acute cholecystitis and cholelithiasis. Histologic evaluation of the resected mass revealed a malignant tumor with prominent keratinization, confirming the diagnosis of an invasive primary pure SCC of the gallbladder. Microscopic examination showed direct infiltration to the liver, duodenum, and stomach. This case report describes the hospital course of a patient with SCC of the gallbladder and suggests that gallbladder cancer should be considered as part of the differential diagnosis in elderly patients presenting with acute cholecystitis. In addition, this article will review existing literature to examine the utility of different diagnostic techniques and treatment modalities available in the management of gallbladder cancer.

Highlights

  • Primary pure squamous cell carcinoma (SCC) of the gallbladder is a locally invasive cancer characterized by prominent keratinization, in the form of keratin pearls, without evidence of malignant glandular transformation [1]

  • In a population-based study conducted by the Centers for Disease Control and Prevention (CDC), the incidence rate of primary gallbladder cancer (GBC) in the United States was 1.13 per 100,000 persons per year from 2007 to 2011

  • Pure primary SCC of the gallbladder is a rare type of gallbladder cancer

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Summary

Introduction

Primary pure SCC of the gallbladder is a locally invasive cancer characterized by prominent keratinization, in the form of keratin pearls, without evidence of malignant glandular transformation [1]. This subtype of gallbladder cancer (GBC) is theorized to originate either from squamous metaplasia of an existing adenocarcinoma or from a metaplasia-dysplasiacarcinoma sequence [1,2,3,4,5,6,7]. Due to the paucity of cases reported, clear guidelines on therapeutic management are not well defined. The efficacy of radiotherapy and chemotherapy is debatable, it may have some role in palliative management [10, 11]

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