Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 7, 2008; 14(41): 6428-6431
Published online Nov 7, 2008. doi: 10.3748/wjg.14.6428
Port site and distant metastases of gallbladder cancer after laparoscopic cholecystectomy diagnosed by positron emission tomography
Jian-Bin Hu, Xiao-Nan Sun, Jing Xu, Chao He
Jian-Bin Hu, Xiao-Nan Sun, Jing Xu, Department of Radiation Oncology of Sir Run Run Shaw Hospital, Sir Run Run Shaw institute of Clinical Medicine of Zhejiang University, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China
Chao He, Department of Colorectal Surgery of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China
Author contributions: Hu JB and Sun XN contributed equally to this work; Hu JB, Sun XN and He C decided the topic and collected the data; and Hu JB and Xu J wrote the paper.
Correspondence to: Chao He, Department of Colorectal Surgery of Sir Run Run Shaw Hospital, Sir Run Run Shaw institute of Clinical Medicine of Zhejiang University, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China. drhechao@yahoo.com.cn
Telephone: +86-571-86006782
Received: June 20, 2008
Revised: August 16, 2008
Accepted: August 24, 2008
Published online: November 7, 2008
Abstract

We report port site and distant metastases of unsuspected gallbladder cancer after laparoscopic cholecystectomy diagnosed by positron emission tomography (PET) in two patients. Patient 1, a 72-year-old woman was diagnosed as cholelithiasis and cholecystitis and received laparoscopic cholecystectomy. Unsuspected gallbladder cancer was discovered with histological result of well-differentiated squamous cell carcinoma of the gallbladder infiltrating the entire wall. A PET scan using F-18-fluorodeoxyglucose (FDG-PET) before radical resection revealed residual tumor in the gallbladder fossa and recurrence at port site and metastases in bilateral hilar lymph nodes. Patient 2, a 69-year-old woman underwent laparoscopic cholecystectomy more than one year ago with pathologically confirmed unsuspected adenosquamous carcinoma of stage pT1b. At 7-mo follow-up after surgery, the patient presented with nodules in the periumbilical incision. Excisional biopsy of the nodule revealed adenosquamous carcinoma. The patient was examined by FDG-PET, demonstrating increased FDG uptake in the right lobe of the liver and mediastinal lymph nodes consistent with metastatic disease. This report is followed by a discussion about the utility of FDG-PET in the gallbladder cancer.

Keywords: Gallbladder cancer; Positron emission tomography; Fluorodeoxyglucose