ABSTRACT
Fibroadenoma of the gallbladder is extremely rare tumor, with only two cases reported in the world. It is characterized by abundant loose edematous connective tissue, glandular structure, polypoid structure covered by epithelia, and a filamentous pedicle. We report a case of 78-year-old woman histopathologically diagnosed after surgery. Macroscopically, the tumor was a dark-greenish solid mass with a short stalk, filling the gallbladder cavity, and it measured 11.5 x 4.0 x 3.5 cm in diameter. Microscopically, the tumor was composed of abundant loose stroma and a glandular component. Some of the glandular cells had hyperchromatic nuclei with disturbed polarity and were positively stained by p53 (30%) and Ki-67 (30-40%). Part of the stromal component revealed hypercellularity with an irregular nucleus, mitosis (2-3 cells/10 high-power fields), and positivity for Ki-67 (20%) and p53 (50%). We diagnosed this peculiar tumor as "fibroadenoma of the gallbladder with borderline malignancy". We present the details of this extremely rare case and discuss the pathological findings, comparing them to those in the two previously reported cases and to carcinosarcoma of gallbladder.
Subject(s)
Fibroadenoma/pathology , Gallbladder Neoplasms/pathology , Aged , Female , Fibroadenoma/chemistry , Gallbladder Neoplasms/chemistry , HumansABSTRACT
A 72-year-old man with common bile duct cancer was treated by pylorus preserving pancreatoduodenectomy with D3 lymph node dissection and preventive radiotherapy at hepaticojejunostomy. At 4 months after surgery, CT demonstrated multiple liver metastatic tumors. Single drug chemotherapy, UFT 600 mg, was started. After 6 months, the liver metastatic tumor could not be seen by CT. UFT may be a first candidate for chemotherapy for recurrence of bile duct cancer.
Subject(s)
Adenocarcinoma/drug therapy , Adenocarcinoma/secondary , Antineoplastic Agents/administration & dosage , Bile Duct Neoplasms/drug therapy , Common Bile Duct , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Tegafur/administration & dosage , Uracil/administration & dosage , Aged , Bile Duct Neoplasms/pathology , Bile Duct Neoplasms/radiotherapy , Bile Duct Neoplasms/surgery , Drug Administration Schedule , Drug Combinations , Humans , Male , Radiotherapy, High-Energy , Remission InductionABSTRACT
This is, to our knowledge, the first report of a fibroma originating in the pancreas in which preoperative imaging findings or explicit descriptions of histopathologic observations are clearly described. A 64-year-old man was referred to our hospital for further evaluation of a pancreatic mass. Clinical examination and laboratory analysis revealed no abnormal findings, except for mild elevation of serum trypsin (550 ng/ml). Abdominal ultrasonogram, computed tomographic scan, magnetic resonance imaging, and angiography demonstrated a well-demarcated circular mass in the tail of the pancreas. A laparotomy was performed on April 26, 1995. The tumor was observed to be tan-colored and smooth, and was localized in the front of the pancreas tail, suggesting that it had arisen from the pancreatic capsule. The patient underwent enucleation of the tumor. The resected tumor presented macroscopically as a fibrous nodule measuring 5.5 x 6.0 cm. The pathological diagnosis was fibroma. Immunohistochemically, spindle cells were positive for vimentin and negative for alpha-smooth muscle actin, desmin, S-100, and neuron-specific enolase.
