Abstract
This paper describes a very rare case of AFP-producing gallbladder carcinoma presenting with acute cholecystitis, together with an immunohistological study. A 58-year-old man was diagnosed as acute cholecystitis and underwent emergency cholecystectomy. The gallbladder swelled and was occupied with soft and necrotic tissue intraluminally. Histopathologically the large part of the lesion was necrotic change, and its central part and adhered portion to the gallbladder wall were confirmed poorly differentiated adenocarcinoma partly invaded the subserosa.
The serum level of AFP was 6750ng/ml preoperatively, and other tumor markers such as CEA and CA19-9 were within normal limits. After the operation, the level of AFP was rapidly reduced within normal limits. Cancer cells showed clear cytoplasm and composed of polygonal tumor cells mainly in solid pattern and partly in glandular structure, and about 70% of cancer cells immunohistochemically stained positive to AFP. We presumed that this case was derived from dysdifferentiation to malignant germ cell tumor. About 4 months later an increase in AFP level occurred again when multiple liver metastasis was detected. A strong relationship between AFP producing gallbladder carcinoma and liver metastasis was suggested.
