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Presented by Ralph Hruban, M.D. and prepared by Jeffrey Seibel, M.D. Ph.D.
Case 6: This 37-year-old female presented with severe abominal pain.
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1. Question
Week 49: Case 6
This 37-year-old female presented with severe abominal pain. Imaging revealed a small mass in the gallbladder and a separate mass in the head of the pancreas.images/JS0716case6a.jpg
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images/JS0716case6d.jpgCorrect
Answer: Adenocarcinoma and Small cell carcinoma
Histology: The lesion in the gallbladder proved to be a moderately differentiated adenocarcinoma. The lesion in the pancreas proved to be metastatic small cell carcinoma in a peripancreatic lymph node.
Discussion: Small cell carcinomas of the gallbladder are relatively rare. Maitra et al. (Am J Surg Pathol 2001 May;25(5):595-601) recently studied 12 small cell carcinomas of the gallbladder and found that most arose in association with a non-small cell carcinoma. Survival was uniformly poor, with a mean survival of 10.7 months (range, 3-25 months). Maitra et al. studied these small cell carcinomas at the molecular level and, in contrast to pulmonary small cell carcinomas, p16INK4a function appears to be abrogated more frequently in these carcinomas.
Incorrect
Answer: Adenocarcinoma and Small cell carcinoma
Histology: The lesion in the gallbladder proved to be a moderately differentiated adenocarcinoma. The lesion in the pancreas proved to be metastatic small cell carcinoma in a peripancreatic lymph node.
Discussion: Small cell carcinomas of the gallbladder are relatively rare. Maitra et al. (Am J Surg Pathol 2001 May;25(5):595-601) recently studied 12 small cell carcinomas of the gallbladder and found that most arose in association with a non-small cell carcinoma. Survival was uniformly poor, with a mean survival of 10.7 months (range, 3-25 months). Maitra et al. studied these small cell carcinomas at the molecular level and, in contrast to pulmonary small cell carcinomas, p16INK4a function appears to be abrogated more frequently in these carcinomas.
