Squamous Cell and Adenosquamous Carcinoma of Gall Bladder: a Clinicopathological Study of 8 Cases Isolated in 94 Cancers

Abstract

Adenosquamous/squamous cell carcinoma (AS/SCC) of the gall bladder is a rare histopathologic subtype that accounts for 1 to 12% of all the gall bladder carcinomas (GBC). Literature on these malignancies is limited. A retrospective analysis of 8 cases (study group) of pathologically proven AS/SCC of the gallbladder among 94 patients who underwent surgery for GBC from January 2001 to December 2014 was done. Twenty-four conventional gall bladder adenocarcinoma cases were selected as control group after matching for age and gender. Mean patient age was 57.8 years and six were females. Clinical presentation did not seem to be too different among the study and control group. Average tumor thickness was significantly higher in AS/SCC cases as compared to the control group (mean 3.1 versus 1.44 cm; = 0.001). Immunohistochemistry for Ki-67 in adenosquamous carcinoma of the gall bladder showed much higher proliferative index in squamoid area than the adenocarcinoma areas (mean 31.3 versus 16.8%; = 0.0004). Study group showed 87.5% patients were in higher stage whereas only 37.5% of the patients in control group presented at a higher stage. AS/SCC of the gall bladder presented at an advanced stage. Higher proliferation index in squamous component of adenosquamous carcinomas may account for higher T stage in these malignancies.

Characteristics and survival prognosis of patients with pure squamous cell carcinoma of the gallbladder

“…The squamous cell component of GBC has been reported to have a doubling proliferation capacity as compared with the glandular component (doubling time of 81 days versus doubling time of 166 days). This can be confirmed by the corresponding results of immunostaining for proliferating cell nuclear antigen (20.55% versus 11.40%, P = 0.0029) and immunohistochemistry for Ki‐67 (31.3% versus 16.8%, P = 0.0004) 17–19 . These experimental data could provide a reliable explanation for the aforementioned clinical findings.…”

“…This can be confirmed by the corresponding results of immunostaining for proliferating cell nuclear antigen (20.55% versus 11.40%, P = 0.0029) and immunohistochemistry for Ki-67 (31.3% versus 16.8%, P = 0.0004). [17][18][19] These experimental data could provide a reliable explanation for the aforementioned clinical findings. Similarly, the larger tumour volume, more advanced SEER historic stage and more distant metastasis of pure SCC versus ASC in this study can be explained plausibly by its higher proportion of (exclusively) squamous contents, although some of the results did not reach statistical significance.…”

A Case Report on Adenosquamous Carcinoma of Gallbladder: A Very Rare Malignancy

“…Prognosis depends upon factors such as histologic type, histologic grade, and stage of the tumor. The overall five-year survival rate of adenosquamous carcinoma is less than 5% with a median survival of fewer than six months [19].…”

Pure squamous cell carcinoma of the gallbladder in a patient with perforated calculus cholecystitis

“…2,5 SCC of the gallbladder on histopathological examination have prominent keratinisation with keratin pearls, intercellular bridges and keratohyalin granules and often have areas of squamous metaplasia distant from malignancy. 10 Microscopic evaluation often demonstrates central deposition of keratin within infiltrative nests. 5…”