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Alpha-fetoprotein-producing clear cell carcinoma of the gallbladder with neuroendocrine differentiation.
[carcinoma of the gallbladder]
An
uncommon
case
of
alpha-fetoprotein
(
AFP
)
producing
clear
cell
carcinoma
of
the
gallbladder
with
neuroendocrine
differentiation
in
a
78
-
year
-old
Japanese
woman
,
who
complained
of
epigastralgia
,
is
reported
.
Macroscopically
,
the
nodular
infiltrative
type
of
tumor
,
measuring
approximately
4
.
5
×
3
.
5
cm
in
size
,
was
located
in
the
fundus
of
the
gallbladder
.
Histologically
,
the
tumor
was
composed
of
clear
cell
carcinoma
with
AFP
production
,
non-
clear
cell
adenocarcinoma
with
neuroendocrine
differentiation
,
and
poorly
or
undifferentiated
carcinoma
with
extensive
ulceration
.
Carcinoma
in
situ
was
found
in
the
surrounding
gallbladder
epithelium
.
Her
postoperative
laboratory
tests
showed
a
decrease
in
AFP
levels
to
normal
.
The
clinical
and
pathologic
significance
of
AFP
production
or
neuroendocrine
differentiation
in
the
gallbladder
carcinomas
have
thus
far
remained
completely
obscure
.
However
,
we
should
recognize
the
entity
of
this
tumor
because
the
accurate
diagnosis
of
primary
clear
cell
carcinoma
of
the
gallbladder
may
have
important
therapeutic
implications
.
