Pinheiro Rodrigo Nascimento, Fontoura Renata P, Rodrigues Letícia L P, Netto José Donato S, Sarmento Bruno José Q
Surgical Oncology of Base Hospital Institute, Brasilia, Federal District, Brazil.
Academic League of Oncology, Base Hospital Institute, Brasilia, Federal District, Brazil.
J Surg Case Rep. 2020 Jun 17;2020(6):rjaa107. doi: 10.1093/jscr/rjaa107. eCollection 2020 Jun.
Gallbladder cancer (GBC) is a rare disease characterized by its aggressiveness. Resection with free tumour margins is the sole curative treatment and, in incidental findings, surgical reapproach is recommended for segmentectomy IVb and V or wedge resection of the gallbladder fossa and lymphadenectomy. Here we report a case of gallbladder adenocarcinoma as an incidental finding in a fragment in its lumen with no wall involvement evidentiated. The patient was reoperated for resection of the gallbladder bed with hepatic hilum and cystic duct lymphadenectomy, later evidentiated as free of residual disease. The normality of the bile ducts evidenced by imaging studies, in addition to signs of chronic cholecystitis corroborate to GBC diagnosis. We suspect that the fragment was detached gallbladder polypoid neoplastic lesion. Despite the lack of clinical manifestations, the fast surgical interventions and the histopathological analysis of the material was probably a prognostic determinant for the patient.
胆囊癌(GBC)是一种罕见的侵袭性疾病。切缘无肿瘤残留的切除术是唯一的根治性治疗方法,对于偶然发现的病例,推荐对IVb和V段进行肝段切除术或胆囊窝楔形切除术并进行淋巴结清扫。在此,我们报告一例胆囊腺癌偶然发现于胆囊腔内一个片段,未发现明显的胆囊壁受累。患者接受再次手术,切除胆囊床、肝门和胆囊管淋巴结清扫,术后病理显示无残留疾病。影像学检查显示胆管正常,此外慢性胆囊炎的体征也支持胆囊癌的诊断。我们怀疑该片段是脱落的胆囊息肉样肿瘤性病变。尽管缺乏临床表现,但快速的手术干预和对标本的组织病理学分析可能是该患者预后的决定因素。