PRIMARY POORLY DIFFERENTIATED SQUAMOUS CELL CARCINOMA OF THE GALLBLADDER: RARE CLINICAL PRESENTATION

Ljubomir Ognjenovikj; Kristijan Veleski; Gjorgji Trajkovski; Kristijan Ivanoski; Blagica Krsteska

Ljubomir Ognjenovikj University Clinic for Digestive Surgery, Faculty of Medicine, "St.Cyril and Methodius" University in Skopje, North Macedonia
Kristijan Veleski General Hospital Borka Taleski, Prilep, North Macedonia
Gjorgji Trajkovski University Clinic for Digestive Surgery, Faculty of Medicine, "St.Cyril and Methodius" University in Skopje, North Macedonia
Kristijan Ivanoski University Clinic for Digestive Surgery, Skopje, North Macedonia
Blagica Krsteska Institute of Pathology, Faculty of Medicine, "St. Cyril and Methodius" University in Skopje, North Macedonia

Abstract

Abstract

Squamous cell carcinoma of the gallbladder (SCC) is a rare histological subtype, accounting for less than 2% of all gallbladder carcinomas. It is most often diagnosed in an advanced stage due to non-specific symptoms, infiltrative growth, and early locoregional invasion. Early recognition of infiltration and biliary obstruction is crucial for surgical planning. We present a patient with right upper quadrant abdominal pain for a couple of months. Contrast-enhanced CT of the abdomen revealed an irregularly thickened gallbladder wall with a mass formation and pronounced pericholecystic infiltration. Loss of the boundary towards segment VI of the liver was noted, suggesting local invasion. The patient underwent surgical treatment. Intraoperatively, extensive tumorous infiltration was identified, tumour mass within segment VI of the liver and compressing the extrahepatic bile ducts. A radical cholecystectomy with wedge hepatic excision and dissection of the hepatoduodenal ligament was performed. Due to the involvement of the choledochus, it was ligated, and a hepatojejunostomy T-L was performed with a smooth operative and postoperative course. Pathological examination is the gold standard for the diagnosis of squamous cell carcinoma. Tumor tissue showed specific microscopic features of squamous differentiation, which are distinct from the more common adenocarcinoma. Immunohistochemistry is the technique that uses specific markers to confirm the diagnosis and rule out other types of cancer. In our case, the tumor cells were positive for CKAE1/AE3 and p63.

Keywords: gallbladder carcinoma, CT diagnostics, squamous cell carcinoma, immunohistochemistry, biliary obstruction.

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