Abstract
A 61-year-old man who visited a hospital because of eruption was found to have impaired hepatic function and dilatation of the intrahepatic bile ducts by ultrasonography, and was referred to our hospital. Abdominal MRI showed stenosis of the middle portion of the extrahepatic bile duct. Carcinoma of the bile duct was suggested and the patient was operated on. During surgery, the gallbladder was felt hard and the induration was present like it had invaded the middle portion of the extrahepatic bile duct. Accordingly we etiologically inferred that the primary lesion was gallbladder carcinoma which invaded the middle portion of the extrahepatic bile duct, and performed cholecystectomy, resection of the extrahepatic bile duct, and resection of segments 4a and 5 of the liver. Histological studies of the resected specimen revealed that gallbladder lesion, the primary foci, was histologically adenocarcinoma, where as the metastatic foci in the resected liver showed different histological type of adenosquamous cell carcinoma.
It has been viewed that adenosquamous carcinoma and squamous cell carcinoma of the gallbladder originate from squamous cell metaplasia of adenocarcinoma. We present this case here because it is interesting in terms of substantiating the view.
