Soyama Akihiko, Tajima Yoshitsugu, Kuroki Tamotsu, Tsuneoka Noritsugu, Ohno Shinichiro, Adachi Tomohiko, Eguchi Susumu, Kanematsu Takashi
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Hepatogastroenterology. 2011 Nov-Dec;58(112):2118-20. doi: 10.5754/hge10140.
Squamous cell carcinoma (SCC) of the gallbladder is frequently detected at an advanced stage because of its tendency to infiltrate adjacent organs. In addition, more rapid growth of this type of carcinoma compared to that of adenocarcinoma, the most frequent subtype of gallbladder carcinoma, has been reported. Although it is not rare to find squamous cell carcinoma components in cases other than the usual adenocarcinoma of the gallbladder, these cases must be distinguished from those of pure squamous cell carcinoma, as diagnosed in the present case. Pure squamous cell carcinoma is characterized by a well-localized growth, no visceral metastasis, and a rarity or lack of lymph node metastasis, even when the tumor has grown to a large size locally. Prognosis of SCC of the gallbladder has generally been considered poor. Nevertheless, long-term survival after curative resection in patients with SCC of the gallbladder has been sporadically reported. We performed extended right hemihepatectomy with portal vein resection after portal vein embolization for a 55-year-old woman with advanced SCC of the gallbladder. The patient has not developed any signs of recurrence 40 months after the surgery. Although such radical surgery remains challenging, it may lead to a favorable outcome in selected patients with advanced SCC of the gallbladder.
胆囊鳞状细胞癌(SCC)由于易于浸润邻近器官,常于晚期被发现。此外,与胆囊癌最常见的亚型腺癌相比,这种类型的癌生长更为迅速。尽管在胆囊非典型腺癌病例中发现鳞状细胞癌成分并不罕见,但这些病例必须与本病例中诊断的纯鳞状细胞癌相区分。纯鳞状细胞癌的特点是生长局限、无内脏转移,即使肿瘤在局部已生长至很大尺寸,也很少或没有淋巴结转移。胆囊鳞状细胞癌的预后通常被认为较差。然而,偶有胆囊鳞状细胞癌患者在根治性切除术后长期存活的报道。我们对一名55岁患有晚期胆囊鳞状细胞癌的女性患者进行了门静脉栓塞后扩大右半肝切除术并切除门静脉。该患者术后40个月未出现任何复发迹象。尽管如此激进的手术仍然具有挑战性,但对于部分晚期胆囊鳞状细胞癌患者可能会带来良好的结果。