PMC8327361_01
Radiology studies revealed SIT anomaly. (A) Dextrocardia in the chest X-ray image, right-to-left reverse transposition in (B) thoracic and (C) abdominal computed tomography (CT) images.
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Initial chest X-ray scan found a mirror-image dextrocardia (Figure 1A), and further computed tomography (CT) revealed a complete, right-to-left reverse transposition of the organs in the thoracic cavity and the abdomen (Figure 1B and C), confirming her congenital anomaly of SIT.
Preoperative CT scan indicated the diagnosis of gallbladder cancer in the SIT setting. (A) The CT images in the non-enhanced, arterial, portal venous, and equilibrium phases. (B) The coronal view showing tumor's involvement of transverse colon. (C) The CT angiography demonstrating significant vascular abnormalities.
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A contrasted CT scan revealed a 6.3 cm x 4.5 cm mass at the gallbladder bottom, with involvement of the transverse colon and the left lateral liver (Figure 2A and B). Multiple vascular variations were also seen in addition to the right-to-left reversal anomaly (Figure 2C).
Pathology studies confirmed the diagnosis of gallbladder cancer. (A) The resected sample with adjacent colon and liver tissues. (B) Cross-sectional profile showing huge gallbladder mass and multiple gallstones. (C) H & E staining showing tumor's involvement of colon. (D) H & E staining of gallbladder adenosquamous carcinoma.
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Gross anatomy showed multiple gallstones in the gallbladder and a huge tumor at the gallbladder bottom, invading the transverse colon and the liver (Figure 3A and B). Final pathology revealed a moderately differentiated adenosquamous carcinoma of the gallbladder, invading the submucosa of the transverse colon (Figure 3C and D), further confirmed by immunohistochemical staining showing positive P63, P53, CK5/6, CK19, CK7, CK20, and CDX2, and negative ERBR expression (Figure 4).
Immunohistochemistry assays suggested (A) positive P63, (B) positive CK5/6, (C) positive CK7, and (D) positive CK19 expression. The scale bars indicate 100 mum.
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Final pathology revealed a moderately differentiated adenosquamous carcinoma of the gallbladder, invading the submucosa of the transverse colon (Figure 3C and D), further confirmed by immunohistochemical staining showing positive P63, P53, CK5/6, CK19, CK7, CK20, and CDX2, and negative ERBR expression (Figure 4).