A CASE OF UNDIFFERENTIATED SPINDLE CELL CARCINOMA OF THE GALLBLADDER

Abstract

A 73-year-old man was referred to the hospital because a tumor of the gallbladder was pointed out by ultrasonography at another hospital on November 19, 1996. The patient had been suffering from right hypochondralgia, body weight loss, and repeated fever and pain since April of the year. On ad-mission, WBC was 18, 200/mm³, ALP was 960IU/l, and γ-GTP was 103IU/l. Imaging procedures visualized the gallbladder as an 8×7cm, relatively demarcated solid tumor with necrotic center; tumors with the diameter of less than 3cm in S4b, 6, and 8 of the liver; and swollen paraaortic lymph nodes. Angiography revealed that the tumor was hypovascular and there was an encasement of the cystic artely. With a diagnosis of gallbladder carcinoma, hepatic resections (S4a+5+6) were performed by using 800ml of autol-ogous blood transfusion on December 2. Histologically, it was undifferen-tiated spindle cell carcinoma of the gallbladder, composed of sarcomatoid portion mostly with severe tumor necrosis and adenocarcinoma component partially. The patient was discharged from the hospital 24 days after the operation. Thereafter, PEIT for hepatic metastasis was unsuccessful and the patient died of liver failure 8 months after the operation.