A CASE REPORT OF PROTRUDING TYPE OF GALLBLADDER CANCER, DIAGNOSED BY PTCCS AND PTCS

Abstract

We report a case of protruding type of gallbladder cancer 22×19×17mm in size, and insist on utilization of Percutaneus Transhepatic CholeCystoScopy (PTCCS) and Percutaneus Transhepatic CholangioScopy (PTCS). The patient was a 66-year-old female presenting with a chief complaint of epigastric discomfort and weight loss, there was no sign of jaundice, ultrasonography revealed a tumor locating on the dorsal side of the middle part of the bile duct, a stenosis of the bile duct due to compression by the tumor, a dilatation of the hepatic duct, and cholecystolithiasis. CT, HDG, PTC, PTCCS and PTCS were performed to make the diagnosis. Then the tumor was diagnosed to be a protruding type of gallbladder cancer with metastatic lymph nodes in hepatoduodenal ligament, inf iltlating the common bile duct. Biopsy from the protrusion in the fundus of gallbladder on PTCCT revealed a well differentiated adenocarcinoma. Biopsy from a stenosis area of the bile duct on PTCS revealed identical adenocarcinoma cells, infiltlating the submucosal layyer. As mentioned above, a definite histological diagnosis could be made preoperatively.