PMC4818317_01
Abdominal computed tomography reveal the gallbladder carcinoma.. (A) The axial view of contrast-enhanced CT. (B) The coronal view of contrast-enhanced CT. Contrast-enhanced CT demonstrating increased gallbladder wall thickness and a low density irregular mass within the gallbladder. The mass was diagnosed as gallbladder cancer with invasion into the liver (arrows).
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Computed tomography (CT) revealed an irregular gallbladder mass involving the liver (Fig. 1).
Abdominal computed tomography and PET-CT reval a splenic tumor.. (A) Contrast-enhanced CT demonstrating a 4-cm low density splenic mass (arrow) considered to represent splenic metastasis 3 months after initial surgery. (B) PET-CT demonstrated uptake of FDG in the spleen. No other intra-abdominal organ metastases or peritoneal dissemination were observed. The mass was diagnosed as a solitary splenic metastasis. (C) Contrast-enhanced CT demonstrating a 6.5-cm enlarging splenic mass (arrow) and a 1-cm nodule (arrowhead) in the liver segment 8, 5 months after initial surgery.
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Enhanced CT imaging revealed a low density mass in the spleen (Fig. 2A). Fluorodeoxyglucose positron emission tomography (FDG-PET) demonstrated abnormal FDG accumulation in the spleen (Fig. 2B). Five months after the initial surgery, CT imaging revealed an enlarging splenic tumor and new liver metastasis in segment 6, indicating a poor response to chemotherapy (Fig. 2C).
Macroscopic view of the cut specimen reveal the splenic tumor.. Cut surfaces of resected and fixed specimen from the second operation. The splenic tumor was found to have a diameter of 6.7 cm.
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The cut surface of the resected specimen revealed a whitish splenic mass with a diameter of 6.7 cm (Fig. 3).
Histopathologically demonstrated the primary gallbladder adenosquamous carcinoma and splenic tumor.. Representative histological images of (A) the primary gallbladder adenosquamous carcinoma and (B) the splenic metastasis (hematoxylin-eosin stain, x40). Both had features consistent with adenosquamous carcinoma.
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Histopathologically, the splenic and liver tumors were found to be adenosquamous carcinoma, consistent with metastasis of the primary GB carcinoma (Fig. 4).