Pure Squamous Cell Carcinoma of Gallbladder – A Rare Entity

Abstract

Case Report Carcinoma of gallbladder is the most common malignancy of biliary tract and 5 th most common malignancy of gastrointestinal tract. Most common histological type being Adenocarcinoma. Though areas of squamous differentiation may be found in adenocarcinoma, pure squamous cell variant is very rare which accounts to less than 1% of all gallbladder carcinoma. To rule out adenosquamous variant the whole specimen must be meticulously studied. Gallbladder carcinoma is more common in women and usually seen in patients older than 50 years of age. Most are asymptomatic but at later stages It usually presents with pain abdomen mimicking features of cholecystitis. Although common mode of investigations is ultrasonography and CT scan, gallbladder cancer is commonly diagnosed incidentally after routine cholecystectomy. Gallbladder cancer carries a poor prognosis specially the squamous cell variant. In most cases at the time of diagnosis it already metastasizes to liver silently but 5 years survival rate can be improved if diagnosed before involving the liver. In our case a 50 years non-smoker multiparous woman presented with pain abdomen and vomiting for 7-8 months. USG and CT scan of abdomen revealed dilated lumen with mass in gallbladder along with calculi in both gallbladder and bile duct. She underwent radical cholecystectomy. On gross gallbladder showed multiple stones with eroded wall and ulcerative area in lumen measuring 3x2x5cm.Microscopic examination revealed gallbladder carcinoma of squamous cell variant without hepatic involvement after thorough examination. Squamous cell carcinoma because of its rarity and aggressiveness carries an outmost importance in its accurate diagnosis.