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

Abstract

Undifferentiated pleomorphic giant cell adeno-carcinoma of the gall bladder (GB) is an extremely rare condition and is usually an incidental diagnosis. Here, we describe a rare case of gall bladder carcinoma in a 50 year old lady who presented with upper abdominal pain and palpable lump in the right hypochondrium. Computed tomography and Ultrasonography of the abdomen showed an ill-defined giant heterogeneous soft tissue mass involving gall bladder and adjacent liver parenchyma with obvious regional adenopathy. Metastatic work-up was abnormal and the patient underwent radical cholecystectomy. Histopathology and immunohistochemistry (IHC) study revealed Undifferentiated carcinoma or pleomorphic giant cell adenocarcinoma of gall bladder involving the adjacent hepatic parenchyma. Patient received post-op adjuvant chemotherapy and is under monthly follow-up. The present case emphasizes the need for better detection, evaluation and analysis of such rare entities, to identify their natural course and effective treatment modalities.