1/75. Small-cell carcinoma of the gallbladder: report of a case.We report herein the case of an 81-year-old woman in whom a mass in the gallbladder was revealed by an ultrasound examination conducted as part of a follow-up study for a silent gallstone. The mass showed evidence of invasion into the adjacent liver parenchyma. Under the tentative diagnosis of malignant neoplastic disease originating in the gallbladder, a cholecystectomy with partial hepatectomy was performed. Histological examination of the tumor confirmed a diagnosis of small-cell carcinoma of the gallbladder, which is considered to be a rare type of neoplasm.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/75. Primary carcinoid tumor of the gallbladder: resection of a case metastasizing to the liver and analysis of outcomes.Gallbladder carcinoid tumor is a rare and aggressive neoplasm, usually lacking specific symptoms, as they typically are unassociated with the carcinoid syndrome, despite frequent hepatic spread. The patient was an 81-year-old man with right upper quadrant pain who underwent radical surgery for carcinoid tumor of the gallbladder with liver metastasis (preoperative diagnosis, carcinoma). We analyzed the outcome of previously reported cases of gallbladder carcinoid. Increasing tumor size and depth of invasion progressively compromised the 2-year survival. These findings underscore the importance of early detection.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
3/75. Metastases to the human mandible.Two clinical cases are reported of mandibular swelling caused by metastatic jaw neoplasms. They analyse. The clinical characteristics of the swelling are analysed and all laboratory and radiographic tests performed are examined. It is concluded that metastatic localisations in the maxillofacial bone are very rare, but that the mandible is certainly the most frequent site. The authors also highlight the fact that the presence of metastatic lesions in the jaw may be the first symptom of the neoplastic disease.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
4/75. Fine needle aspiration cytodiagnosis of primary squamous cell carcinoma of the gallbladder. Report of two cases.BACKGROUND: Cytologic descriptions of the diagnosis of the rare primary carcinoma of the gallbladder are sparse. The obstacles to the diagnosis are ascribed to vague symptoms and inaccessibility of the gallbladder to biopsy. We describe two cases of primary squamous cell carcinoma of the gallbladder that were diagnosed using fine needle aspiration (FNA) cytology. CASES: Both patients were elderly females with vague symptoms of abdominal pain, jaundice, loss of weight, anorexia and mild fever. Imaging studies showed enlargement of the gallbladder with a soft tissue mass in the fundus and abnormally thickened wall, indicative of a tumor. Also, in case 1, gallstones and enlarged, matted paraaortic and porta hepatis lymph nodes were present. FNA of the gallbladder was done after selection of a suitable puncture site and needle positioning, which was confirmed by computed tomography. The aspirated material was collected as needle and syringe washings, and from half the material filter preparations were made and stained for cytologic study, while the remainder was used for making cell blocks for histologic study. Both cases showed cytohistologic features of a moderately well differentiated, necrotizing squamous cell carcinoma characterized by keratinizing malignant cells with orangeophilic cytoplasm. In both cases immunostaining for high-molecular-weight keratins (AE1/AE3) and cytokeratin (CAM 5.2) was positive, while staining for carcinoembryonic antigen, B72.3 and other markers was negative. CONCLUSION: This study further confirmed that with the widespread use of more-sophisticated imaging techniques, the gallbladder is becoming more readily accessible to visualization. In view of this, FNA cytodiagnosis holds promise as a noninvasive technique in the diagnosis of gallbladder neoplasms.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
5/75. Stromal tumor of the gallbladder with phenotype of interstitial cells of cajal: a previously unrecognized neoplasm.We report a small, well-demarcated stromal tumor of the gallbladder in a 69-year-old woman. The tumor and associated cholelithiasis led to chronic cholecystitis symptoms. The wall of the gallbladder contained a 2.4-cm hypocellular nodule composed of bland spindle-shaped cells that were immunoreactive for vimentin, CD34, and CD117. With the latter antibody, which stains interstitial cells of cajal (ICC), the neoplastic cells appear fusiform with elongated bipolar projections or dendritic-like cytoplasmic projections. The gallbladder wall adjacent to the tumor contained numerous CD117-positive cells in close contact with the normal smooth muscle cells, whereas two of 10 gallbladders with minimal chronic cholecystitis showed only a few CD117-positive cells. These findings provide evidence that this stromal tumor of the gallbladder shows ICC differentiation similar to some stromal tumors of the gut. The presence of numerous ICC in the uninvolved gallbladder wall suggests that this tumor might have evolved through hyperplasia of ICC.- - - - - - - - - - ranking = 4keywords = neoplasm (Clic here for more details about this article) |
6/75. Small cell carcinoma of the gall bladder: case report and review of literature.Small cell carcinoma of the gall bladder is a very rare tumor. The neoplasm is highly lethal, metastasizes early, and may cause death shortly after diagnosis. Here we report a 56 year old male with small cell carcinoma of the gall bladder metastatic to the liver. He attained partial remission with 5 fluouracil, cisplatin based chemotherapy. However, the disease progressed after 3 months and salvage chemotherapy with docetaxel and caboplatin failed to produce any tumour response. He succumbed to the illness 13 months after cholecystectomy.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
7/75. Paradoxical brain embolism from thrombus associated with vena caval filter in a patient with cancer.A 71-year-old man experienced sudden onset of hemiparesis and aphasia. He had a 4-month history of gallbladder cholangiocarcinoma, complicated with a postoperative deep-vein thrombosis (DVT) that necessitated a vena caval filter placement. diffusion-weighted magnetic resonance imaging of the brain showed multiple hyperintense foci. magnetic resonance spectroscopy was compatible with cerebral infarction. Abdominal computed tomography showed a thrombus in the inferior vena cava extending through the filters. A transcranial Doppler bubble study revealed the presence of a right-to-left shunt. Paradoxical cerebral embolism must be considered in patients with DVT who have new onset neurologic deficits even in the presence of a caval filter.- - - - - - - - - - ranking = 0.0011042578167619keywords = brain, cerebral (Clic here for more details about this article) |
8/75. Seeding from early stage gallbladder carcinoma after laparoscopic cholecystectomy.In the last years laparoscopic cholecystectomy has become the "gold standard therapy" in the treatment of symptomatic cholelitiasis, but it is necessary to keep into account some problems and risks that can arise from laparoscopic technique. One of these risks is represented surely by the disregarding of a gallbladder carcinoma. The authors report a case of peritoneal seeding of an unsuspected gallbladder carcinoma following laparoscopic cholecystectomy. The first histologic diagnosis was chronic ulcerous cholecystitis with adenomiosis but 2 months later the metastasis developed at the umbilical port site, at another port site and to the right lobe of the liver. Another histological sampling of the gallbladder specimen was performed and this time a little intra mucous gallbladder adenocarcinoma was found (T1 stage). While the most part of literature data concern advanced stage of the disease at the time of operation (T2, T3) only few reports regard early stage neoplasm. Therefore this risk is present not only in advanced stages of gallbladder carcinoma but even in cases of early stage cancers. After a laparoscopic cholecystectomy all specimen should be opened and inspected. If there is a gallbladder wall irregularity and if there was a bile spillage it is advisable to perform a preoperative histologic examination.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
9/75. A novel approach to gallbladder cancer in a Jehovah's Witness.Transfusion of blood or blood products peri- or postoperatively is often necessary in patients undergoing liver resections for hepatic or biliary tract neoplasms. In jehovah's witnesses this inevitably poses a difficult dilemma for clinicians. A 66-year-old female Jehovah's Witness with a T1b gallbladder cancer was referred to our specialist unit for further treatment after having had a routine laparoscopic cholecystectomy in another hospital. Although an abdominal computed tomography scan preoperatively showed a normal liver with no evidence of regional lymph node involvement, histologically the tumor was found in the posterior wall of the gallbladder adherent to the liver bed and had a full thickness involvement of the muscular layer, raising suspicion of a local invasion into the liver bed. The patient, having refused liver resection, was treated with a laparoscopic radiofrequency ablation under intraoperative ultrasound guidance using a newly developed "cooled-tip" needle and a 500-kHz radiofrequency generator. A "zone of necrosis" measuring 3.5 cm in diameter was created in the liver bed and adjacent tissues. The procedure lasted 90 min with no blood loss. Postoperatively, the patient was discharged on the third postoperative day and remained disease free at the 9-month follow-up. Although the follow-up in this case was too short to determine the long-term result of this approach, we believe that this is a single unique case posing a challenging problem to clinicians for which radiofrequency ablation may have a role in offering an alternative to major resections.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
10/75. carcinosarcoma of the gallbladder with chondroid differentiation.carcinosarcoma of the gallbladder is an uncommon neoplasm. We herein report the case of a patient with carcinosarcoma of the gallbladder with chondroid differentiation, treated by cholecystectomy with liver segmentectomy and lymph node dissection for a tumor which occupied the entire gallbladder and spread to the liver. Histologically, the tumor contained two distinct components: a mixture of both well and poorly differentiated tubular adenocarcinoma and sarcomatoid tissue with chondroid differentiation. From a review of the literature, it was seen that carcinosarcomas of the gallbladder could be divided into two groups: one group with apparent sarcomatous differentiation, such as chondroid, osteoid, and rhabdomyosarcomatous differentiation, and the other group, of carcinosarcomas with a sarcomatous portion composed of anaplastic spindle cells. Each group had a poor prognosis in spite of surgical resection of tumors. Our patient died of peritoneal dissemination 7 months after surgery.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
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