すい後部に巨大なリンパ節転移を伴った胆嚢腺内分泌細胞癌の１例

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  • A CASE OF ADENO-ENDOCRINE CELL CARCINOMA OF THE GALLBLADDER WITH A GIANT LYMPH NODE METASTASIS

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We report a case of adeno-endocrine cell carcinoma of the gallbladder with a giant lymph node metastasis. A 71-year-old woman referred to the hospital for right dorsalgia with a diagnosis of gallbladder cancer was found to have a solid tumor 4 cm in diameter at the gallbladder and a lymph node 5 cm in diameter at the back of the pancreas on computed tomography (CT). Magnetic resonance cholangio-pancreatography (MRCP) showed a defected image due to the solid tumor. Pancreaticoduodenectomy and extended cholecystectomy (+D3+18) were conducted. Microscopically, the gallbladder tumor consisted of poorly differentiated adenocarcinoma and ednocrine cell carcinoma (ecc) cells for the most part and poorly differentiated adenocarcinoma only on the surface. On immuno stainings were positive for NSE and negative for chromogranin and grinelius. Lymph node metastasis was seen only at the back of the pancreas head, which was composed of ecc cells. The endocrine cell carcinoma is reported to have a high malignant potential. Frequent lymph node metastasis, hepatic involvement, and vascular invasion occur, in the early state. Our case showed extraordinal occurrence, as solitary huge lymph node metastasis of ecc. The patient is followed carefully and has been asymptomatic for seven months after the operation.

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