Introduction : Squamous cell carcinoma is a rare histopathologic subtype of gallbladder cancer. Few studies have reported its tendency for liver infiltration and poor prognosis compared to adenocarcinoma. We present a case of squamous cell carcinoma of the gallbladder.

Methods : A 70-year-old female patient had sustained right flank pain and weight loss of 10 kg in 4 months. On CT scan, either intrahepatic cholangiocarcinoma with direct invasion to gall bladder or gallbladder cancer with direct invasion to liver segments 4 and 5 was suspected. Serum tumor markers were within normal ranges. She had a normal liver function, and no distant metastasis was observed.

Results : We performed anatomical S4/5 segmentectomy with cholecystectomy en bloc. The frozen section of the cystic duct margin was negative for malignancy. The operation time was 180 min, and the estimated blood loss was 650 ml. Final histopathological analysis revealed a well-differentiated squamous cell carcinoma with a focal adenocarcinoma component (<5%), and tumor stage was T3. All surgical resection margins were confirmed to be negative for tumor cell. She was discharged without any complications at POD 8. However, CT scan and PET-CT performed 2 months after operation indicated intraabdominal seeding metastases. Thus, the patient planned for chemotherapy.

Conclusions : Squamous cell carcinoma of the gallbladder had similar preoperative characteristics with adenocarcinoma. Despite curative resection with a negative margin, it had aggressive manifestation.