Primary Pure Keratinising Squamous Cell Carcinoma: A Rare Malignancy with Aggressive Behaviour

Abstract

A 70-year-old female presented with clinical symptoms of dyspepsia and right upper quadrant pain for 3 months. On examination, patient had mild pallor and icterus and no lymphadenopathy. Mild tenderness was present on abdominal palpation but no palpable lump was found. Ultrasonography revealed gall stones along with thickened and irregular gall bladder wall. During the open cholecystectomy procedure, gall bladder was enlarged, hard and was not adherent to any of the adjacent tissue. Liver and extra hepatic biliary tree appeared normal. No lymph nodes were detected.Grossly the gall bladder was enlarged measuring11x5x4cm. External surface was congested. No mass was seen externally. On cutting open, gall bladder wall was irregularly thickened with an exophytic grey white tumour filling the entire body of the gall bladder measuring 7x5x4cm. A single stone was present at the fundus and the rest of the mucosa appeared atrophic [Table/ Fig-1].

A case of primary squamous cell carcinoma of the gallbladder with local invasion of the liver and peritoneum, and metastasis to the omentum

“…(2017) [4] 1 75 F RUQ pain, WBC (15,000/µL), and Normal Liver Function Tests (LFTs) CT: GB wall thickening, pericholecystic fluid, irregular soft tissue mass in GB fundus US: 3.8 cm Heterogeneous GB fundal lesion with small calcifications Dx: Cholecystectomy, duodenal/stomach resection Pure 1° SCC of the GB T4NxMx Local invasion of the liver, duodenum, and stomach Alive at the time of publication Chandna et al. (2016) [7] 1 70 F Dyspepsia, RUQ pain, icterus, and no palpable mass CT: Not performed US: Gallstones with a thickened irregular GB wall Dx: Cholecystectomy Keratinizing SCC confined to the serosa Locally resected tumor with negative margins Not reported Hoshimoto et al. (2016) [8] 3 SCC 1 ASC Mean of 68 2:2 (M:F) Not reported Imaging findings were not reported SCC (40%-90%) T2 and T3 stages Local invasion of the liver Not reported Kalayarasan et al.…”