Sekine Kiwako, Nakaseko Yuichi, Nakashima Keigo, Kamada Teppei, Takahashi Junji, Koja Manabu, Fukushima Naoko, Iwase Ryota, Usuba Teruyuki, Ogawa Masaichi, Suzuki Yutaka
Department of Surgery, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara, Tochigi, 329-2763, Japan.
Department of Surgery, The Jikei University Katsushika Medical Center, 6-41-2, Aoto, Katsushika-Ku, Tokyo, 125-8506, Japan.
Surg Case Rep. 2024 Nov 18;10(1):263. doi: 10.1186/s40792-024-02057-8.
Primary solitary fibrous tumors (SFTs) of the gallbladder are rare. Here, we report the case of a patient who underwent surgical treatment for a primary SFT originating in the gallbladder.
A 48-mm gallbladder tumor was detected in a 70-year-old man using abdominal ultrasonography at a primary hospital, and he was subsequently referred to our department. A 50-mm enhanced tumor in the gallbladder was identified using computed tomography. Magnetic resonance imaging revealed a smooth-marginated tumor with hyperintensity on T2-weighted imaging. 18F-Fluorodeoxyglucose positron emission tomography confirmed high-level fluorodeoxyglucose uptake in the gallbladder tumor in the early phase without increasing uptake in the later phase. Surgical resection was planned to evaluate the tumor diagnosis. Initially, we performed open cholecystectomy with wedge resection of the gallbladder bed. Intraoperative pathological examination suggested gallbladder cancer; therefore, we performed radical surgery, including resection of the common bile duct, extended radical lymphadenectomy, and choledochojejunostomy. Ultimately, the final pathological examination revealed an SFT originating from the gallbladder with a negative surgical margin. Postoperatively, the patient developed bile leakage that was treated with tube drainage. The patient recovered satisfactorily and was discharged on postoperative day 20. At 24 months postoperatively, the patient was in good general condition without recurrence.
We report a rare case of a primary SFT originating in the gallbladder. Clinicians should be aware that SFT can be found in the gallbladder, and when it is difficult to make a preoperative diagnosis, surgical treatment should be considered.
原发性胆囊孤立性纤维瘤（SFT）较为罕见。在此，我们报告一例因原发性胆囊SFT接受手术治疗的患者病例。
一名70岁男性在基层医院行腹部超声检查时发现一个48毫米的胆囊肿瘤，随后转诊至我科。计算机断层扫描显示胆囊内有一个50毫米的强化肿瘤。磁共振成像显示肿瘤边界光滑，在T2加权成像上呈高信号。18F-氟脱氧葡萄糖正电子发射断层扫描证实胆囊肿瘤在早期有高水平的氟脱氧葡萄糖摄取，后期摄取无增加。计划进行手术切除以评估肿瘤诊断。最初，我们进行了开腹胆囊切除术并楔形切除胆囊床。术中病理检查提示胆囊癌；因此，我们进行了根治性手术，包括切除胆总管、扩大根治性淋巴结清扫术和胆总管空肠吻合术。最终，最终病理检查显示为起源于胆囊的SFT，手术切缘阴性。术后，患者出现胆漏，经置管引流治疗。患者恢复良好，术后第20天出院。术后24个月，患者一般状况良好，无复发。
我们报告了一例罕见的原发性胆囊SFT病例。临床医生应意识到胆囊中可发现SFT，当术前难以诊断时，应考虑手术治疗。
