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Primary malignant melanoma of the gallbladder.

A primary malignant melanoma of the gallbladder in a 44-years-old man is presented. The typical pathologic findings in the now eight reported cases are analysed. The clinical course of the present case was determined by multiple metastases to the brain. The histogenesis of these rare tumors of the gallbladder is still obscure.

Adult↗

Identification of the regional lymphatic system of the gallbladder by vital staining.

In 21 patients with biliary tract cancer dye was injected into the lymphatic system of the gallbladder to determine the extent of its regional lymph nodes. A volume of 0.1-0.3 ml 1 per cent indigo carmine solution was injected directly into lymphatic vessels of the gallbladder in eight patients and into lymph nodes (cystic node or pericholedochal nodes) in 13 patients during radical surgery for biliary tract cancer. The lymphatic system was visualized in a total of 14 patients. The dye descended around the bile duct, flowed into the cystic node, the pericholedochal nodes and the lymph nodes posterior to the head and neck of the pancreas, and finally reached the interaortocaval nodes adjacent to the left renal vein. The stained lymphatic tissue was regarded as the regional lymphatic system of the gallbladder. These nodes should be completely resected during radical surgery for gallbladder cancer.

Bile Duct Neoplasms↗

Genetic alterations in gallbladder carcinoma.

Gallbladder carcinoma is an aggressive cancer associated with a poor prognosis. Unfortunately, the precise molecular mechanisms of development and progression of this highly malignant tumor remain unknown. It is still unclear whether loss of heterozygosity (LOH) plays a significant role in gallbladder carcinogenesis, but recent studies have found a high incidence of LOH at several chromosomes in gallbladder carcinoma. In particular, LOH on chromosomes 1p, 3p, 5p, 8p, 9p, 9q, 13q, 16q, and 17p has been highlighted and LOH on 3p, 9p, 13q, 16q, and 17p has been detected in preneoplastic lesions and in the early phase of gallbladder carcinoma during multistep carcinogenesis. The proto-oncogene, K-ras, is the best known genetic alteration in several human neoplasms, including gallbladder carcinoma. The accumulation of these genetic changes leads to a disruption in cell-cycle regulation and also continuous cell proliferation. We present an overview of K-ras alteration and LOH at several chromosome loci in gallbladder carcinoma. Further studies of the molecular mechanism in gallbladder carcinoma and the delineation of the genetic influence involved should promote our understanding of gallbladder carcinogenesis.

Carcinoma↗