1/92. A case of primary adenosquamous/squamous cell carcinoma of gallbladder directly invaded duodenum.A rare case of primary gallbladder carcinoma is reported. A 67 year-old woman was admitted to our hospital for treatment of suspected duodenal carcinoma. A series of radiographic examinations demonstrated a giant tumor involving the duodenum, gallbladder, pancreatic head, and transverse colon. These extensions made it difficult to identify the primary origin of the carcinoma. Pancreatoduodenectomy, cholecystectomy, and resection of the transverse colon were performed. Macroscopically, ulcerative lesions were seen in both the gallbladder and the duodenum. Microscopic examination revealed adenosquamous cell carcinoma of the gallbladder, invasive of the adjacent organs, including circumferential invasion of the second portion of the duodenum. The patient tolerated the operation well and was discharged 28 days post-operatively, but died of liver metastasis 4 months after surgery. Local invasion of the surrounding tissues is characteristic of adenosquamous/squamous cell carcinoma of the gallbladder. Although surgery for cure is deemed possible, the rapid growth rate of this type of tumor may cast doubt on the value of extensive radical surgery.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/92. A long-term survival patient with advanced gallbladder cancer massively metastasizing to the liver.A case of gallbladder carcinoma was reported. A 42-year-old woman was admitted with epigastralgia. Abdominal ultrasonography, computed tomography, and other diagnostic modalities suggested gallbladder carcinoma with multiple liver metastases. These findings indicated no surgical procedure because of the advanced nature of her disease. After the hepatic arterial chemoinfusion therapy, her multiple liver metastatic lesions showed a decrease in size and number. Therefore, extended left lobectomy of the liver with gallbladder and bile duct resection were performed. Five years after initial operation, a solitary liver metastatic lesion (S5) was diagnosed by ultrasonography. Partial resection of the liver was performed for the liver metastasis, and her postoperative recovery was uneventful and had a good follow-up course. One year after the second operation bone metastases occurred, therefore, peroral administration of UFT (tegafur Uracil) and radiation therapy for the metastatic lesions of sternum and lumbar vertebra (L1) were performed.- - - - - - - - - - ranking = 0.77777777777778keywords = gallbladder (Clic here for more details about this article) |
3/92. The role of lymphatic drainage of the liver in gallbladder cancer: a case report.We report a case of a patient with a unique lymph node relapse after right hepatectomy and aggressive lymph node dissection for gallbladder cancer. There was extensive involvement of the hepatic parenchyma from the primary tumor, but no extension to the lymph nodes or other adjacent organs. Seventeen months later, the patient underwent re-dissection of the retroperitoneal lymph nodes with right nephrectomy and partial resection of the vena cava because of lymph node recurrence at the hilum of the right kidney. This pattern of lymph node metastasis to the right side of the vena cava from gallbladder cancer invading the liver is probably due to the distinct lymphatic drainage of the liver.- - - - - - - - - - ranking = 0.66666666666667keywords = gallbladder (Clic here for more details about this article) |
4/92. Solitary hepatocellular carcinoma fed by the cystic artery: limitation of transcatheter arterial embolization.PURPOSE: To clarify the limitations of transcatheter treatment for hepatocellular carcinoma (HCC) with parasitic feeders from the cystic artery. methods: Three male patients had a solitary HCC (average diameter 3 cm) fed by the cystic artery among 221 patients with HCC from 1994 to 1997. One tumor was nourished entirely from the cystic artery arising from the medial branch of the left hepatic artery, and two tumors were fed partially by the cystic arteries arising from the anterior inferior branch of the right hepatic artery. We analyzed the indications for transcatheter treatment for these three patients. RESULTS: We chose not to embolize the cystic artery for fear of necrosis of the gallbladder. Although embolization of the anterior branch of the right hepatic artery was performed in one patient with a tumor fed partially by the cystic artery, only half the tumor was embolized. Two patients underwent hepatic resection, and one received percutaneous ethanol injection therapy. At follow-up of 28-40 months (average 33 months) all patients are alive. CONCLUSION: Feeding by the cystic artery represents a limitation of TAE for HCC.- - - - - - - - - - ranking = 0.11111111111111keywords = gallbladder (Clic here for more details about this article) |
5/92. Solid mesenchymal hamartoma of the liver in adult.This paper presents an unusual solid mesenchymal hamartoma of the liver (MHL) in adult. A well defined solid mass in the left lobe of the liver was found in a 57-year-old female. Preoperative radiologic examinations demonstrated solid mass with multifocal calcifications abutting the gallbladder. By light microscopy, the lesion was composed of dense fibrous stroma with hyalinization, bile ducts and thick-walled vessels without hepatocytes. The solid and hyalinized mesenchymal component would suggest an unusual degenerative change representing a burnt-out MHL.- - - - - - - - - - ranking = 0.11111111111111keywords = gallbladder (Clic here for more details about this article) |
6/92. Advanced gallbladder carcinoma with liver metastasis showing a favorable response after intra-arterial infusion chemotherapy: report of a case.A 66-year-old woman visited a local clinic due to general fatigue. After undergoing examinations at our hospital, the patient was diagnosed to have advanced gallbladder carcinoma with metastasis to the liver and cholecystolithiasis, After receiving a cholecystectomy, we performed chemotherapy by the intra-arterial infusion of low-dose cisplatin and 5-fluorouracil via hepatic artery, and observed its marked effect on the tumors by computed tomography. The level of carcinoembryonic antigen decreased from 114.5 ng/ml to 0.8 ng/mg, and carbohydrate antigen 125 decreased from 1 094 U/ml to 75 U/ml. The present result suggests that this therapy may be useful for some selected patients with an advanced gallbladder carcinoma.- - - - - - - - - - ranking = 0.66666666666667keywords = gallbladder (Clic here for more details about this article) |
7/92. Is choledocholithiasis a late complication of nonresectional therapies for hepatocellular carcinoma?We present 3 patients who developed choledocholithiasis 10, 13, and 12 months after percutaneous ethanol injection and/or transcatheter arterial chemoembolization for hepatocellular carcinoma. Since none of these patients had stones in the gallbladder or in the bile ducts before treatment, bile duct stones might have resulted from local injury in the bile ducts by percutaneous ethanol injection and/or transcatheter arterial chemoembolization. choledocholithiasis may be a late complication of nonresectional and local therapies for hepatocellular carcinoma tumors.- - - - - - - - - - ranking = 0.11111111111111keywords = gallbladder (Clic here for more details about this article) |
8/92. Synchronous carcinoma of the gallbladder in a patient with intrahepatic bile duct carcinoma.An 83-year-old woman, diagnosed as having cholelithiasis, was admitted to the Department of Surgery, Nippon Medical School, with right hypochondrial pain. ultrasonography and computed tomography revealed a mass in the gallbladder fundus and a hypovascular tumor in the anterior segment of the liver. magnetic resonance imaging showed stenosis of the intrahepatic bile duct and dilatation of its proximal portion. She was diagnosed as having intrahepatic bile duct carcinoma combined with gallbladder carcinoma. At laparotomy, there was evidence of multiple peritoneal metastases and intraoperative histological examination of the gallbladder tumor revealed adenocarcinoma. Accordingly, only cholecystectomy and needle biopsy of the liver tumor was performed. Histological examination of the gallbladder revealed papillary adenocarcinoma invading the muscularis propria with medullary growth or intermediate stroma. There was no microvessel invasion, no perineural invasion and no lymph node involvement. On the other hand, the liver tumor was a cholangiocarcinoma with a well-differentiated tubular pattern. Therefore, this was a rare case of synchronous carcinoma of the gallbladder associated with intrahepatic bile duct carcinoma.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
9/92. 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 = 0.66666666666667keywords = gallbladder (Clic here for more details about this article) |
10/92. cholecystitis caused by hemocholecyst from underlying malignancy.Massive hemobilia is a well recognized clinical entity, particularly when it presents with jaundice, GI bleeding, and biliary pain. However, occult hemobilia is more difficult to diagnose and has seldom been reported because of its clinically silent nature. In fact, this is usually overlooked until complications arise. Hemocholecyst or clot within the gallbladder may rarely occur in this setting, leading to cystic duct obstruction and cholecystitis. Most previous reports describe cholecystitis resulting from hemocholecyst after iatrogenic trauma. We describe two cases in which hemocholecyst occurred from underlying malignancies, both resulting in cholecystitis (acute or chronic).- - - - - - - - - - ranking = 0.11111111111111keywords = gallbladder (Clic here for more details about this article) |
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