Surgical resection of advanced gallbladder squamous cell carcinoma accompanied by infiltration of the surrounding organs and general peritonitis

Highlights • The gallbladder of “pure” squamous cell carcinoma is a rare subtype of gallbladder cancer. • The advanced stage and infiltration of the gallbladder cancer into surrounding organ. • Radical resection for the advanced gallbladder carcinoma accompanied with general peritonitis is rare case.
Introduction Squamous cell carcinoma (SCC) of the gallbladder is rare, accounting for merely 1–3% of all gallbladder cancers. Presentation of case A 59-year-old Japanese man was referred to our hospital with a chief complaint of right lower abdominal pain. He was diagnosed with gallbladder cancer after comprehensive testing. Computed tomography (CT) imaging revealed an enlarged gallbladder, and a lumen full of tumors (maximum tumor size was 90 mm in diameter.). The patient was, therefore, admitted to our department for the operation. After admission, the patient developed a fever and pain in his lower right abdomen. Palpation revealed masses in the abdomen and right hypochondrium. Blood tests revealed elevated levels of inflammatory markers. Therefore, a conservative treatment approach was performed prior to surgery. After then, the patient’s abdominal symptoms did not seem to worsen, and his vital signs were stable, leading us to continue the conservative treatment approach. The operation was conducted on a semi-urgent basis. Surgical findings: The patient was diagnosed with gallbladder cancer with traverse colon infiltration. We performed hepatic resection (S4a + S5), biliary reconstruction, lower (pyloric) gastrectomy, right hemicolectomy, and ileostomy. Histopathological findings revealed that the patient was diagnosed with advanced gallbladder SCC. Discussion Primary SCC of the gallbladder is associated with poor prognosis. Continuing to collect and document such cases will help to resolve this matter. Conclusion This report details our experience in treating a case of “pure” gallbladder SCC, a rare subtype of gallbladder cancer. Despite the complicating general peritonitis, we were still able to safely perform a radical resection to remove it.