Small Cell Carcinoma of Gall Bladder

Won, Yong Sung; Chin, Hyung Min; Suh, Young Jin; Chun, Kyoung Hwa; Park, Woo Bae; Kim, Jun Gi; Chun, Chung Soo

Abstract

Small or oat cell carcinoma arising in a gall bladder (GB) is very rare. It occupies about 5% or less of total GB cancers. A woman suspicious of GB empyema was admitted in our department via emergency room to get an operation. Emergent cholecystectomy was done, which was followed by intraoperative frozen sectional microscopic examinations of locoregionally enlarged lymphnodes around GB and a spherical mass, 1 cm in diameter, which was located at the neck of GB on computerized tomograms taken just before the operation. On frozen section, the mass in GB showed malignant features but not penetrating serosa and metastatic tumor involvement in regional lymphnodes. Then she got an additional regional lymphnodes dissection around GB and common bile duct, which was followed by hepatic wedge resection around GB bed. After confirming permanent pathology proven as small cell carcinoma of GB, we started 5-fluorouracil-based chemotherapy and external irradiation, total of 5,000 cGy, on her. Five months after the operation, she developed metastatic cervical lymphnodes on her left side, proven by fine needle aspiration cytology. Then systemic chemotherapy with etoposide and cisplatinum was initiated, and it showed some regression of the size of the conglomerated metastatic lymphnodes. We experienced one case of small cell carcinoma of GB in a woman, which is a very rare pathologic type of gall bladder cancer that shows very poor prognosis needing extensive adjuvant treatments, but presents highly malignant and devastating features.