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.

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Primary endocrine cell carcinoma of the gallbladder is rare. We report a case of endocrine cell carcinoma of the gallbladder coexisted with adenocarcinoma in a 76-year-old woman. In preoperative examinations for gastric cancer, an abdominal computed tomography and an ultrasonography revealed a tumor in the fundus of the gallbladder. The intraoperative pathological diagnosis was adenocarcinoma of the gallbladder. Therefore, a liver bed resection with lymph node dissection was performed. The tumor showed nodular protruded type and was 19×18mm in size on diameter. Histological findings demonstrated that the tumor consisted of adenocarcinoma and endocrine cell carcinoma. In the area of endocrine cell carcinoma, the tumor cells revealed nest and trabecular pattern. Positive Chromogranin A and Grimelius stainings were observed in these cells. The definite diagnosis of adeno-endocrine cell carcinoma was made. Lymph node metastasis was seen in the hepatoduodenal ligament. A transition between these two type carcinomas was observed. The fact appeared to support a theory that endocrine cell carcinoma might be originated from adenocarcinoma. We consider that this endocrine cell carcinoma might have a high malignant potential, because lymph node metastasis and vascular invasion were observed in the early state.

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