Small or oat cell carcinoma arising in a gall bladder (GB) is very rare. It occupies about 5% or less of total GB cancers. A woman suspicious of GB empyema was admitted in our department via emergency room to get an operation. Emergent
cholecystectomy
was done, which was followed by intraoperative frozen sectional microscopic examinations of locoregionally enlarged lymphnodes around GB and a spherical mass, 1 cm in diameter, which was located at the neck of GB on computerized tomograms taken
just
before the operation. On frozen section, the mass in GB showed malignant features but not penetrating serosa and metastatic tumor involvement in regional lymphnodes. Then she got an additional regional lymphnodes dissection around GB and common
bile
duct, which was fo
llowed by hepatic wedge resection around GB bed. After confirming permanent pathology proven as small cell carcinoma of GB, we started 5-fluorouracil-based chemotherapy and external irradiation, total of 5,000 cGy, on her. Five months after the
operation, she developed metastatic cervical lymphnodes on her left side, proven by fine needle aspiration cytology. Then systemic chemotherapy with etoposide and cisplatinum was initiated, and it showed some regression of the size of the
conglomerated
metastatic lymphnodes. We experienced one case of small cell carcinoma of GB in a woman, which is a very rare pathologic type of gall bladder cancer that shows very poor prognosis needing extensive adjuvant treatments, but presents highly
malignant
and
devastating features.
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