Jena Suvendu Sekhar, Meher Dibyasingh
Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi 110060, India.
Department of General Surgery, VMMC & Safdarjung Hospital, New Delhi 110029, India.
Int J Surg Case Rep. 2022 Jan;90:106710. doi: 10.1016/j.ijscr.2021.106710. Epub 2021 Dec 20.
Squamous cell carcinoma of the gall bladder is a rare but aggressive tumor. It has a wide variety of presentations. Presentation as a liver abscess is a rare condition only 2 cases reported in the literature before.
A 45-year-old male patient presented to the emergency with complaints of fever, right upper quadrant pain, and jaundice. On evaluation, an initial diagnosis of the liver abscess was made. Due to the deteriorating condition of the patient, he was taken up for surgery. Upon exploration, there were multiple deposits over the bilateral lobes of the liver, so a controlled drainage of abscess cavity was done with biopsy from the wall of the gall bladder and liver metastasis was taken which showed squamous cell carcinoma of gall bladder with liver metastasis. The patient was given gemcitabine and oxaliplatin as palliative chemotherapy. He died after 11 months of presentation.
The aggressive and advanced nature of the disease at the presentation poses a formidable challenge in managing such patients but early diagnosis and surgical management can provide long term benefits.
胆囊鳞状细胞癌是一种罕见但侵袭性强的肿瘤。其临床表现多样。以肝脓肿形式呈现是一种罕见情况,此前文献仅报道过2例。
一名45岁男性患者因发热、右上腹疼痛和黄疸到急诊科就诊。经评估,初步诊断为肝脓肿。由于患者病情恶化,遂接受手术。术中发现肝脏双侧叶有多处肿物,于是对脓肿腔进行了控制性引流,并从胆囊壁取组织活检,同时取了肝转移灶组织,结果显示为胆囊鳞状细胞癌伴肝转移。给予患者吉西他滨和奥沙利铂进行姑息化疗。患者在就诊11个月后死亡。
该疾病在就诊时的侵袭性和晚期性质给此类患者的管理带来了巨大挑战,但早期诊断和手术治疗可带来长期益处。