Representing 90–95% of all malignant gallbladder neoplasms, adenocarcinoma is by far the most common subtype. Adenosquamous carcinoma is a rare subtype, accounting for only 1–5% of all gallbladder carcinomas. These tumors have been shown to have aggressive biologic behavior, commonly extending to adjacent structures. Some studies have shown that the squamous component often displayed a greater proliferative capacity than the adenocarcinomatous component (possibly even up to twice as fast). Complete surgical resection is currently the mainstay of treatment but the prognosis is often poor. In this paper, we present a case of a 69-year-old male with an AJCC Stage IV moderately differentiated adenosquamous carcinoma of the gallbladder treated with radical cholecystectomy including liver segments IVb, V, VI.
In 2019, Pancreatic cancer became the third leading cause of cancer related mortality in the United States of America. Pancreatic cancer is a fatal malignancy that is predominantly seen in men with advanced age with aggressive course. Ninety percent of cases are adenocarcinoma. Pancreatic adenocarcinoma is very difficult to detect as is usually asymptomatic with no early signs. At least 80% of tumors are unresectable by the time of diagnosis. Despite substantial improvement in the survival rates for other major cancer forms, pancreatic cancer survival rates have remained relatively unchanged since 1960s. Multidisciplinary therapy with a combination of chemotherapy, radiation and surgery performed at high volume centers remains the best chance for cure. We report a rare case of a small T1 pancreatic head carcinoma with underlying chronic pancreatitis presenting with cancerous pericardial effusion and tamponade. Despite the small size of the primary tumor, the extensive pattern of lymphatic occlusion can lead to mesenteric and mediastinal lymphatic spread to the pericardium. US guided emergent pericardiocentesis was performed with removal of 750 cc of serosanguinous fluid. Cytopathological examination of the fluid revealed poorly differentiated pancreatic adenocarcinoma. A Port-A-Cath was placed, and he was referred to the oncology department to start chemotherapy.
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. GISTs of the small bowel are rare, and often present with an abdominal mass and/or bleeding. Chemotherapy and surgery are the mainstay of therapy. Here, we discuss an unusual case of a ruptured jejunal GIST with hemoperitoneum and recurrence despite surgical excision followed by Imatinib treatment. Forty-five cases of ruptured small intestinal GISTs were identified in the literature. Most cases were in males and were found to be at the site of the jejunum.
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