Successful Resection of a Large Rare Composite Tumor (Endocrine Cell Carcinoma and Squamous Cell Carcinoma) of the Gallbladder after Preoperative Arterial and Portal Embolization

Background: We here report a case of a rare composite tumor (endocrine cell carcinoma and squamous cell carcinoma) of the gallbladder in a 71-year-old woman. The tumor, which was diagnosed as carcinoid tumor preoperatively, was about 10 cm in diameter and compressed the hilar plate of the liver. Methods: After decreasing the tumor size by right and middle hepatic arterial embolization and increasing the liver remnant volume by embolization of the right branch of the portal, it was successfully resected by extended right lobectomy of the liver. Results: The treatments of choice for endocrine cell or squamous cell carcinoma arising from the gallbladder have not yet been established. In this case, preoperative arterial embolization was effective, and an aggressive approach using portal embolization resulted in long-term survival for more than 3 years without any sign of recurrence.