Abstract
We experienced a case with gallbladder carcinoma growing limited to the mucosa (T1a), which developed massive lymphatic vessel spread and lymph node metastases.A 72-year-old man was referred to our hospital for the swelling of his gallbladder during a routine ultrasound sonography checkup. We diagnosed the patient with gallbladder carcinoma with lymph node metastasis according to the radiographic findings and performed the open cholecystectomy and lymph node dissection. A histological examination showed poorly differentiated adenocarcinoma, solid type, and the tumor was limited to the mucosa. The number of lymphatic vessels was increased in the tumor and peritumor areas, and cancer cells were observed in the lymphatic vessels, which were detected via D2-40 immunohistochemistry. A careful histological examination and follow-up is required for T1a gallbladder carcinoma.
Highlights
The prognosis of gallbladder carcinoma is poor
Patients with T1a gallbladder carcinoma (GC) are considered to be curable by cholecystectomy without lymph node dissection [2, 3], and no evidence has shown that the lymph node dissection improves the prognosis of T1a GC [4,5,6]
The frequency of lymph node metastases by tumor invasion is as follows: T1a, the tumor invaded into the mucosa 0–2.5 %; T1b, the tumor invaded into muscularis 5–16 %; T2, the tumor invaded into the perimuscular connective tissue 9–30 %; T3, the tumor perforated into the serosa 39–72 %; and T4, directly invaded into other organs 67–80 % [7]
Summary
The prognosis of gallbladder carcinoma is poor. The 5-year survival rate of surgical resection was reported to be 40 % [1]. Case presentation A 72-year-old man was referred to our hospital for the swelling of his gallbladder which was indicated during a routine ultrasound sonography checkup. He had been previously treated for hypertension, diabetes mellitus, and a cerebral infarction. The dilated intrahepatic bile duct was seen in left liver; this finding was consistently observed in the patient’s clinical course and indicated no malignant disease. According to these findings, we diagnosed the patient with gallbladder carcinoma with lymph node metastasis and performed open cholecystectomy and lymph node dissection of the hepatoduodenal ligament.
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