A Rare Presentation of Hepatocellular Carcinoma Infiltrating the Gallbladder

Abstract

Hepatocellular carcinoma (HCC) is a solid tumor of the liver and one of the most common primary tumors of the liver. Lifestyle being a major risk factor for the development of HCC makes it a major public health concern worldwide. HCC rarely infiltrates the gall bladder because it rarely destroys the muscle layer and collagen fibers of the gallbladder wall. We report here a rare case of hepatocellular carcinoma that invaded the gallbladder and was initially misdiagnosed as primary gallbladder malignancy invading the liver.

A case of clear cell-hepatocellular carcinoma accidentally found in the gallbladder wall after laparoscopic resection of gallbladder empyema: Beware of the liver bed

“…Advanced HCC often spreads as intrahepatic metastases, while extrahepatic metastasis is occasionally seen in the lung, bone, adrenal gland, and lymph nodes [4] . Reports of gallbladder invasion or metastasis from HCC are rare even in advanced tumors [1] , [2] , [5] . As there is no peritoneum between the gallbladder and the liver fossa, gallbladder cancer easily invades the liver; however, HCC seldom invades the gallbladder because it rarely destroys the muscle layer or collagen fibres of the gallbladder wall [2] .…”

“…Reports of gallbladder invasion or metastasis from HCC are rare even in advanced tumors [1] , [2] , [5] . As there is no peritoneum between the gallbladder and the liver fossa, gallbladder cancer easily invades the liver; however, HCC seldom invades the gallbladder because it rarely destroys the muscle layer or collagen fibres of the gallbladder wall [2] . In a study of 393 patients with HCC who underwent hepatectomy with cholecystectomy, 8 (1.8 %) had gallbladder metastases without distant metastases.…”

“…Although gallstones are the most common cause of cholecystitis, tumors are rarely discovered along with cholecystitis. Discovering HCC for the first time in cholecystectomy tissue is unusual, since HCC rarely infiltrates the gallbladder [1] , because it rarely destroys the muscle layer and collagen fibres of the gallbladder wall [2] . Here we report a case of HCC that invaded the gallbladder and was accidentally found in a laparoscopic cholecystectomy specimen.…”