A case of gallbladder carcinoma with interesting contrast-enhanced harmonic EUS image

Abstract

This is a case of pT2 (SS) gallbladder carcinoma extending into the Rokitansky-Aschoff sinus and invasive in part. The tumor showed regional difference in proliferation pattern. Pathologically, the tumor had a region with irregular tubular structure tumor cell proliferation pattern and a region with solid structure and dense tumor cell proliferation pattern. Preoperative Contrast-enhanced harmonic EUS showed two regions. One was a region that showed irregular vessel from the early phase and then the whole tumor showing strong enhancement. Another region showed thick tortuous irregular vessels in delay and then the whole tumor was enhanced heterogeneously. This case showed an interesting contrast-enhanced harmonic EUS image that suggests the existence of a different histologic component.