Gallbladder carcinoma with osteoclast-like giant cells

Abstract

Extraskeletal tumors containing multinucleated, osteoclast-like giant cells (OGCs) are uncommon. These neoplasms are most frequently reported in the breast and pancreas. Recently, some authors have suggested that carcinomas containing OGCs may represent a distinct clinicopathological entity with a more favorable prognosis. Occurrence in the gallbladder is extremely rare, with only one previous case. We report here on an additional case of gallbladder carcinoma with an infiltrate of OGCs. A 72-year-old woman presented with postprandial abdominal pain and was found to have a mass in the body of the gallbladder with direct liver invasion. Histological examination showed an adenosquamous carcinoma with an infiltrate of benign OGCs. Immunohistochemical analysis demonstrated that the giant cells were of histiocytic origin. The patient survived for 6 years without evidence of recurrence. This case adds to a small body of literature on gallbladder carcinoma with OGCs. Further studies are required to clearly define the prognostic significance of these giant cells in gallbladder cancer and the differences between adenosquamous carcinoma with OGCs and other gallbladder carcinomas (such as adenocarcinoma and squamous cell carcinoma) with those cells.

Undifferentiated giant cell type carcinoma of the gallbladder with sarcomatoid dedifferentiation: a case report and review of the literature

“…The latter are composed of pleomorphic, undifferentiated giant cells with bizarre nuclei, showing immunohistochemical evidence of epithelial derivation, while displaying an identifiable transition between adenocarcinoma and giant cells [5,6]. However, in our case, there were no demonstrable foci of adenocarcinoma in the tumour.…”

“…Immunohistochemical analysis has demonstrated the giant cells to be of histiocytic origin lacking of epithelial differentiation. These findings may imply that osteoclast-like giant cells are a specialised form of macrophage [6]. …”

“…Moreover, several types of gallbladder carcinoma may contain a variable number of osteoclast-like giant cells differentiating their biological behaviour as well as prognosis [5,6]. Here, we present a case of undifferentiated gallbladder carcinoma exerting an unusual immunophenotype that was shown to be of giant cell type with sarcomatoid dedifferentiation infiltrated by osteoclast-like multinucleated cells.…”

Pleomorphic giant cell adeno-carcinoma gall bladder: a histological rarity and a surgical dilemma

“…cytokeratin positivity), as was the case in our patient, in undifferentiated carcinoma with Osteoclast-like giant cells, the giant cells are more monomorphic and of histiocytic origin (and therefore cytokeratin negative but CD 68 positive). 5,6 This case represents an unusual variant of undifferentiated carcinoma of the gall bladder. The presence of widespread necrosis, high mitotic index, serosal invasion and liver bed infiltration portends a poor post-surgical outcome in this case.…”

Invasive ductal carcinoma of the breast with osteoclast-like giant cells and clear cell features: a case report of a novel finding and review of the literature

“…They have typically been associated with several cancers including gallbladder, liver, and thyroid [12–14]. Agnatis first reported OLGCs as a component of a primary breast malignancy in 1979 [15].…”