Case Report


Comprehensive treatment and experience of a rare case of gallbladder hepatocellular adenocarcinoma

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1 Department of General Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China

2 Department of General Surgery, Xiongxian Hospital, Baoding, Hebei 071800, China

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Miao Tang

Department of General Surgery, The Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, Hebei Province 050000,

China

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Article ID: 100155Z12MT2025

doi: 10.5348/100155Z12MT2025CR

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How to cite this article

Tang M, Hu Z, Gao H. Comprehensive treatment and experience of a rare case of gallbladder hepatocellular adenocarcinoma. J Case Rep Images Surg 2025;11(1):37–41.

ABSTRACT


Introduction: Hepatoid adenocarcinoma (HAC) is an adenocarcinoma with components similar to those of hepatocellular carcinoma, while HAC of the gallbladder is a rare malignant tumor characterized by diagnostic challenges characterized by diagnostic challenges, high malignancy, and poor prognosis, with only case reports available to date. Surgery is currently the best treatment option. With the advancement of gene sequencing technology, we are gradually able to identify the specific gene mutation types of tumors, providing precise and personalized treatment plans for rare tumors, which is a more rational approach. This case exemplifies the use of gene sequencing to guide the comprehensive treatment of gallbladder HAG, achieving excellent outcomes.

Case Report: The patient is a 58-year-old male who presented with jaundice and abdominal pain as the main symptoms. Laboratory tests indicated a significant increase in alpha-fetoprotein (AFP) and mild anemia. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a solid tumor in the gallbladder with local tissue infiltration. The patient underwent radical surgery for gallbladder cancer, and the surgically removed tissue was subjected to immunohistochemical staining, which revealed the tumor to be HAC with focal neuroendocrine differentiation. Genetic sequencing showed BRCA2 rearrangement, CDKN2A/B deletion, and TP53 gene mutation in the tumor. After receiving treatment with Tegafur, Gimeracil, and Oteracil Potassium capsules combined with Olaparib, the patient’s AFP progressively decreased, and multiple follow-up examinations showed no new lesions. Thirteen months later, the patient contracted the COVID-19 virus and subsequently died from lung failure.

Conclusion: Surgery combined with gene sequencing technology is feasible for treating primary gallbladder HAC, providing new insights for the comprehensive treatment of rare tumors.

Keywords: BRCA2, Genetic sequence, Hepatoid adenocarcinoma, Olaparib, Rare case

SUPPORTING INFORMATION


Author Contributions

Miao Tang - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Zeqiang Hu - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published

Hejun Gao - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published

Guarantor of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2025 Miao Tang et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.