Spontaneously ruptured undifferentiated gallbladder carcinoma in a young woman: a rare and aggressive entity

Abstract

Gallbladder cancer is a rare and aggressive malignancy, representing 3%-4% of digestive cancers, and is often diagnosed at advanced stages, resulting in poor prognosis. This case report presents a 30-year-old woman with a 10-day history of right upper quadrant abdominal pain. Laboratory results revealed GB:12250, Hb:10.8 g/dL, Plt:538000, CRP:299 mg/L, with mild liver function disturbance (GGT:36, PAL:46, ASAT:13, ALAT:6, BT/BD:5/3). Imaging revealed a large mass at the gallbladder bed, suspected to be a tubulo-papillary intra-vesicular tumor, along with liver lesions and hydatid cysts. Exploratory laparotomy confirmed a ruptured gallbladder tumor, with histopathological findings indicating undifferentiated carcinoma. Cytology of the peritoneal fluid confirmed malignant cells. The tumor was staged as pT3NxMx, suggesting invasion of adjacent structures with uncertain lymph node and metastasis status. The patient received six cycles of adjuvant chemotherapy with gemcitabine and cisplatin. This report highlights the diagnostic challenges and aggressive nature of gallbladder cancer and presents a rare histological subtype with spontaneous rupture in a young patient, emphasizing the need for early detection and multidisciplinary management.