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Ayabe RI, Wach MM, Ruff SM, Diggs LP, Martin SP, Wiemken T, Hinyard L, Davis JL, Luu C, Hernandez JM. Gallbladder squamous cell carcinoma: An analysis of 1084 cases from the National Cancer Database. J Surg Oncol 2020; 122:716-722. [PMID: 32510655 PMCID: PMC8482609 DOI: 10.1002/jso.26066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/17/2020] [Accepted: 05/15/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND/OBJECTIVES Gallbladder squamous cell carcinoma (SCC) is an uncommon malignancy whose rarity has made it particularly challenging to study. We utilized a national database to shed light on the clinicopathologic characteristics, management patterns, and survival associated with these tumors. METHODS Patients with gallbladder SCC were identified in the National Cancer Database. Clinicopathologic and treatment characteristics were recorded and compared with adenocarcinoma for context. Univariate and multivariable survival analyses were completed for patients who underwent resection. RESULTS Overall, 1084 patients with SCC and 23 958 patients with adenocarcinoma were identified. Compared with those with adenocarcinoma, patients with SCC had higher grade tumors (P < .001) and were diagnosed at a later stage (P < .001). Patients with SCC were more likely to undergo radical cholecystectomy (17% vs 9%; P < .001), but had a higher rate of margin positivity (36% vs 29%; P < .001). SCC histology was associated with worse survival compared with adenocarcinoma, even after adjusting for R0 resections (13 vs 29 months; P < .001). On multivariable analysis, SCC histology was independently associated with abbreviated survival (P = .003). CONCLUSIONS Gallbladder SCCs are aggressive cancers that often present at an advanced stage. Complete surgical extirpation should be pursued when feasible. However, prognosis is worse than that of adenocarcinoma, even after R0 resection.
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Affiliation(s)
- Reed I. Ayabe
- Surgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Michael M. Wach
- Surgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Samantha M. Ruff
- Surgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Laurence P. Diggs
- Surgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Sean P. Martin
- Surgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Timothy Wiemken
- Saint Louis University Center for Health Outcomes Research (SLUCOR), St. Louis, MO USA
| | - Leslie Hinyard
- Saint Louis University Center for Health Outcomes Research (SLUCOR), St. Louis, MO USA
| | - Jeremy L. Davis
- Surgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Carrie Luu
- Division of General Surgery, Department of Surgery, Saint Louis University Hospital, St. Louis, MO USA
| | - Jonathan M. Hernandez
- Surgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
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Jin S, Zhang L, Wei YF, Zhang HJ, Wang CY, Zou H, Hu JM, Jiang JF, Pang LJ. Pure squamous cell carcinoma of the gallbladder locally invading the liver and abdominal cavity: A case report and review of the literature. World J Clin Cases 2019; 7:4163-4171. [PMID: 31832423 PMCID: PMC6906552 DOI: 10.12998/wjcc.v7.i23.4163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/30/2019] [Accepted: 10/15/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Gallbladder squamous cell carcinoma (GBSCC) is a rare subtype of malignancy and accounts for only 2%-3% of gallbladder malignancies. Due to its rapid development, most patients with GBSCC initially present with an advanced stage of the disease and hence a poor prognosis. The clinicopathological and biological features of SCC remain to be fully elucidated, owing to its uncommon occurrence. The majority of currently available data only described individual case reports or series analyses of trivial cases.
CASE SUMMARY A 64-year-old man was admitted for progressively poor abdominal distension and pain. Liver computed tomography (CT) showed infiltration of gallbladder carcinoma into the adjacent liver, and enlarged retroperitoneal lymph nodes. The patient underwent radical cholecystectomy. Part of the mass was grey and soft, and the neoplastic section showed a purulent-necrotic lesion. Hematoxylin and eosin staining revealed a moderately differentiated SCC. Immunohistochemical studies showed strong staining of the tumor for AE1/3 and CK5/6. Staining for CK19, CK7, and CAM5.2 was positive in the cytoplasm. Systemic chemotherapy was not administered because of the patient’s poor physical condition. After five months, CT and magnetic resonance cholangiopancreatography showed multiple metastases in the liver and abdominal cavity.
CONCLUSION Squamous components of GBSCC may explain the complex biological behavior, and CD109 may be involved in the pathogenesis.
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Affiliation(s)
- Shan Jin
- Department of Pathology, the First Affiliated Hospital to Shihezi University School of Medicine and Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
| | - Lu Zhang
- Department of Pathology, the First Affiliated Hospital to Shihezi University School of Medicine and Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
| | - Yuan-Feng Wei
- Department of Pathology, the First Affiliated Hospital to Shihezi University School of Medicine and Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
| | - Hai-Jun Zhang
- Department of Pathology, the First Affiliated Hospital to Shihezi University School of Medicine and Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
| | - Cheng-Yan Wang
- Department of Pathology, the First Affiliated Hospital to Shihezi University School of Medicine and Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
| | - Hong Zou
- Department of Pathology, the First Affiliated Hospital to Shihezi University School of Medicine and Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
| | - Jian-Ming Hu
- Department of Pathology, the First Affiliated Hospital to Shihezi University School of Medicine and Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
| | - Jin-Fang Jiang
- Department of Pathology, the First Affiliated Hospital to Shihezi University School of Medicine and Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
| | - Li-Juan Pang
- Department of Pathology, the First Affiliated Hospital to Shihezi University School of Medicine and Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China
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A case of primary squamous cell carcinoma of the gallbladder with local invasion of the liver and peritoneum, and metastasis to the omentum. Radiol Case Rep 2018; 13:269-274. [PMID: 29487667 PMCID: PMC5826693 DOI: 10.1016/j.radcr.2017.09.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 09/11/2017] [Accepted: 09/25/2017] [Indexed: 11/21/2022] Open
Abstract
Primary squamous cell carcinoma of the gallbladder is a rare entity that comprises approximately 1%-3% of all primary gallbladder cancers. We report the case of a 37-year-old woman who was diagnosed with a locally invasive squamous cell carcinoma of the gallbladder. Surgical pathology revealed a predominantly squamous cell carcinoma composition of the tumor with a few microscopic foci of adenocarcinoma (<1% of tumor). We discuss pertinent clinical features, risk factors, and imaging characteristics to prompt early diagnosis and treatment, which will ultimately lead to improved patient outcomes.
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Jung J, Chae YS, Kim CH, Lee Y, Lee JH, Kim DS, Yu YD, Kim JY. Combined Adenosquamous and Large Cell Neuroendocrine Carcinoma of the Gallbladder. J Pathol Transl Med 2017; 52:121-125. [PMID: 28994275 PMCID: PMC5859238 DOI: 10.4132/jptm.2017.08.20] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/01/2017] [Accepted: 08/20/2017] [Indexed: 12/13/2022] Open
Abstract
Large cell neuroendocrine carcinoma (LCNEC) of the gallbladder is extremely rare and usually combined with other type of malignancy, mostly adenocarcinoma. We report an unusual case of combined adenosquamous carcinoma and LCNEC of the gallbladder in a 54-year-old woman. A radical cholecystectomy specimen revealed a 4.3×4.0 cm polypoid mass in the fundus with infiltration of adjacent liver parenchyma. Microscopically, the tumor consisted of two distinct components. Adenosquamous carcinoma was predominant and abrupt transition from adenocarcinoma to squamous cell carcinoma was observed. LCNEC showed round cells with large, vesicular nuclei, abundant mitotic figures, and occasional pseudorosette formation. The patient received adjuvant chemotherapy. However, multiple liver metastases were identified at 3-month follow-up. Metastatic nodules were composed of LCNEC and squamous cell carcinoma components. Detecting LCNEC component is important in gallbladder cancer, because the tumor may require a different chemotherapy regimen and show early metastasis and poor prognosis.
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Affiliation(s)
- Jiyoon Jung
- Department of Pathology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yang-Seok Chae
- Department of Pathology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chul Hwan Kim
- Department of Pathology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Youngseok Lee
- Department of Pathology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jeong Hyeon Lee
- Department of Pathology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Dong-Sik Kim
- Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Young-Dong Yu
- Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Joo Young Kim
- Department of Pathology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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