Abstract
Endocrine carcinomas of the gallbladder are reported to show a poor prognosis; thus, early diagnosis plus effective therapy are required. We reported two cases of the neoplasms, which showed no elevation of carcinoembryonic antigen or carbohydrate antigen 19-9, and same image findings: ultrasound demonstrated a homogeneous hypoechoic oval gallbladder tumor beneath a granular innermost hyperechoic layer and endoscopic retrograde cholangiography revealed granular contour of the gallbladder tumor. After undergoing cholecystectomy with liver bed fatty tissue extirpation and lymph node dissection, they received postoperative adjuvant chemotherapy. One case visited another hospital because of lumbar and back pain 13 years after surgery and died of liver metastases with carcinomatous peritonitis due to pancreas body cancer 5 months later. The other case died of lymph node metastases 2 years and 8 months after surgery. Ultrasound and pathological correlation in the cases demonstrated that a granular innermost hyperechoic layer and a hypoechoic oval tumor represented a papillary adenocarcinoma confined to the mucosa and an endocrine carcinoma invading the subserosa, respectively. We thereby stress the significance of the ultrasound finding "submucosal hypoechoic tumor with granular mucosal surfaces" for the diagnosis of endocrine carcinoma.
