Squamous cell carcinoma of the gallbladder: an unusual presentation

摘要

Squamous cell carcinoma (SCC) of the gallbladder is a rare and aggressive affection and is responsible for up to 2% of the malignant neoplasms of this organ. While SCC commonly presents as abdominal lump and/or jaundice, some cases with unusual presentations have been reported in literature. Squamous cell carcinoma of the gall bladder may present rarely as empyema or acute cholecystitis. We report here a rather unusual presentation of a case of a squamous cell carcinoma of the gallbladder in a 60-year-old male presenting as pyoperitoneum. Introduction While adenocarcinoma of gallbladder is the common histologic type of gallbladder cancer (80%) (1), Squamous cell carcinoma of the gallbladder is a rare, constituting only 2% of all gallbladder cancers. Thought to arise either from preexisting squamous epithelium or squamous differentiation of adenocarcinoma cells, these tumors have a more aggressive course than adenocarcinoma. We treated a 60-year-old man presenting with pyoperitoneum with gaseous distension of bowel loops due to ileus. Intraoperatively, a growth was found in the gall bladder which was infiltrating nearby tissues and a bile leak was present. Case report A sixty-year-old man presented with complaints of generalized pain in the abdomen for the last month. The pain was associated with low-grade fever, breathlessness and constipation. On examination, there was generalized moderate distension of the abdomen with mild generalized tenderness in the abdomen. Bowel sounds were sluggish. No signs of peritonitis were present. Routine haematological and biochemical examinations were normal except for a low hemoglobin percentage. Ultrasonography of the abdomen showed a mild peritoneal collection with dense internal echoes with right-sided pleural effusion. Bowel loops were distended giving a poor sonological window. X-ray of the abdomen in erect posture showed multiple air-fluid levels in small bowel as well in colon. On USG-guided aspiration of peritoneal fluid, frank pus was aspirated.