Pure squamous cell carcinomas of gall bladder: A series of 4 cases

Introduction: Pure squamous cell carcinoma is an exceptional malignancy with a few case series available in literature. The overall clinical and pathological picture is highly variable and prognosis dismal. Our study describes a series of 4 patients who presented with squamous cell carcinoma of the gallbladder along with their clinico-pathological characteristics. Materials and Methods: The clinical presentation, laboratory investigations, radiological details were retrieved from the hospital records. The gross features and histopathological findings were collected from the departmental archival material and were analyzed by a single pathologist. Result: The clinical and pathological picture of the patients with pure squamous cell carcinoma was highly variable. The radiological features varied from a diffuse thickening of gall bladder wall, a exophytic intraluminal mass in the gall bladder to a large homogenous irregular mass in the right hypochondrium on ultrasonography. The gross features of gall bladder specimens varied from a diffuse infiltrating growth, a polypoid mass arising from the wall, to a large highly friable mass in right hypochondrium infiltrating into adjacent colon. The microscopic features varied from a tumor composed of groups, islands or nests of atypical squamous cells with dyskeratosis and keratin pearl formation to a tumor comprising of cells arranged in solid sheets with areas of comedo necrosis and keratin pearl formation. The prognosis was dismal. Conclusion: The clinical features and overall survival of patients with pure squamous cell carcinoma is more or less similar to the more common adenocarcinoma of gallbladder, however, the no. of cases studied is small to draw conclusions indicating the need for more extensive study.