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Undifferentiated giant cell type carcinoma of the gallbladder with sarcomatoid dedifferentiation: a case report and review of the literature.
[carcinoma of the gallbladder]
Undifferentiated
gallbladder
carcinoma
is
a
rare
entity
.
Among
unusual
types
of
undifferentiated
gallbladder
carcinoma
,
giant
cell
type
carcinoma
is
infrequent
and
,
moreover
,
very
few
cases
of
such
neoplasms
with
osteoclast-like
giant
cells
have
been
documented
.
We
report
a
case
of
undifferentiated
gallbladder
carcinoma
presenting
an
unusual
immunophenotype
that
was
shown
to
be
of
giant
cell
type
with
sarcomatoid
dedifferentiation
infiltrated
by
osteoclast-like
multinucleated
cells
.
An
84
-
year
-old
Greek
man
presented
with
right
upper
quadrant
pain
,
high
fever
,
rigors
,
anorexia
and
weight
loss
during
the
past
month
.
Clinical
examination
revealed
tenderness
in
the
right
upper
abdominal
quadrant
and
a
palpable
gallbladder
.
Blood
tests
showed
elevated
white
blood
-cell
count
and
transaminases
.
Abdominal
ultrasound
and
computed
tomography
demonstrated
a
markedly
distended
gallbladder
,
measuring
16
cm
x
8
cm
,
with
oedema
and
pericholecystic
fluid
,
consistent
with
gallbladder
empyema
.
After
an
open
cholecystectomy
and
an
uneventful
recovery
,
the
patient
was
discharged
on
the
4
(
th
)
postoperative
day
.
On
cut
surface
,
a
2
cm
solid
mass
was
identified
,
obstructing
the
lumen
in
the
neck
of
the
gallbladder
.
Histopathology
and
immunohistochemistry
offered
the
diagnosis
of
an
undifferentiated
,
giant
cell
type
carcinoma
of
the
gallbladder
with
sarcomatoid
dedifferentiation
infiltrated
with
osteoclast-like
giant
cells
.
U
ndifferentiated
,
giant
cell
type
carcinoma
of
the
gallbladder
with
sarcomatoid
dedifferentiation
infiltrated
with
osteoclast-like
giant
cells
is
a
very
infrequent
neoplasm
.
Controversy
exists
over
its
nature
,
as
related
knowledge
remains
incomplete
.
Thorough
histopathological
and
immunohistochemical
evaluation
is
imperative
for
diagnosis
.
Due
to
their
rarity
,
the
biological
behaviour
and
prognosis
of
these
tumours
remain
unclear
.
Diseases
Validation
Diseases presenting
"pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
aniridia
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pleomorphic liposarcoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
trochlear dysplasia
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
This symptom has already been validated