Gallbladder Adenosquamous Cancer With Situs Inversus Totalis: A Case Report and Literature Review

Abstract Background: Situs inversus totalis (SIT) is a rare genetic congenital disease, characterized by complete right-left inversion of all the internal organs. We herein describe a meaningful case which was diagnosed as gallbladder adenosquamous carcinoma, a rare histology type of gallbladder cancer, with SIT. Case presrntaton: A 59-year-old Chinese woman was admitted for persistent epigastric distention and intermittent abdominal pain. The abdominal CT scan revealed a huge mass at the gallbladder bottom, involving the adjacent transverse colon and liver. En-bloc radical resection of the gallbladder cancer, including partial colonectomy and hepatectomy with regional node dissection, followed by colocolostomy and Roux-en-Y choledochojejunostomy, was successfully performed Pathology analysis indicated an adenosquamous carcinoma with positive adenocarcinoma marker (CK7, CK19) and squamous carcinoma markers (CK5/6, P63). Conclusion: The SIT anomaly might increase the risk of malignancies by sharing genome mutations, suggesting the importance of surveillance in the SIT settings.

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Situs Inversus Totalis

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.20.1.63 ◽

2001 ◽

Vol 20 (1) ◽

pp. 63-67 ◽

Cited By ~ 7

Author(s):

Janie Spoon

Keyword(s):

Situs Inversus ◽

Vena Cava ◽

Situs Inversus Totalis ◽

Mirror Image ◽

The Body ◽

Radiographic Examination ◽

Internal Organs ◽

Radiographic Findings ◽

Situs Solitus ◽

The Right

EXTERNALLY, THE HUMAN BODY appears symmetric; if a line is drawn down the middle of the body, each side appears identical. However, this is not true of the internal anatomy. For example, there is one heart, which lies in the left chest, one liver, in the right abdomen, and one stomach, in the left abdomen. The term situs refers to the position or location of an organ, specifically, the position of the atria and abdominal viscera in relation to the midline of the body.1 There are three types of situs: solitus, inversus, and ambiguous. Situs solitus refers to the normal arrangement of organs, with the right atrium, liver, gallbladder, trilobed lung, and inferior vena cava on the right side and the left atrium, stomach, spleen, bilobed lung, and descending aorta on the left side (Figures 1–3). Situs inversus totalis refers to a mirror image reversal of the normal position of the internal organs (Figures 4 and 5). 1 The incidence of situs inversus totalis is 1 in every 8,000 to 25,000 births, and the condition is most often diagnosed by radiographic examination.2Situs ambiguous, often referred to as heterotaxia, is the random arrangement of the internal organs and is associated with splenic abnormalities and congenital heart disease.3 The purpose of this column is to discuss the embryology, pathophysiology, and diagnosis of situs inversus totalis and to review a case study with radiographic findings.

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Angiographic Embolization of a Postpartum Vulvovaginal Hematoma in a Patient with Situs Inversus Totalis: An Effective Second-Line Treatment

Case Reports in Obstetrics and Gynecology ◽

10.1155/2013/323781 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Elias M. Dahdouh ◽

Jacques Balayla ◽

Johanne Dubé

Keyword(s):

Situs Inversus ◽

Primary Treatment ◽

Situs Inversus Totalis ◽

Invasive Technique ◽

Angiographic Embolization ◽

Internal Organs ◽

Artery Ligation ◽

Incision And Drainage ◽

Obstetrical Complication ◽

Life Threatening

Situs inversus totalis is a rare congenital anomaly where asymmetrical positioning of internal organs may affect the surgical and radiological management of certain conditions. Vulvovaginal hematoma is a life-threatening complication of vaginal delivery whose primary treatment usually consists of incision and drainage of the hematoma and ligation of the responsible vessels, followed by wound packing. Failure of these measures to control the bleeding was previously considered as an indication for laparotomy to perform bilateral hypogastric artery ligation and, if needed, a hysterectomy. Relative to major abdominal surgery, selective percutaneous angiographic embolization offers considerable advantages and significant less morbidity. Indeed, angiographic embolization is routinely used as a measure to control refractory pelvic bleeding, though the literature and experience in women with situs inversus totalis are scarce. In this paper, we report a case of postpartum vulvovaginal hematoma in a patient with situs inversus, refractory to conventional treatment, where arteriographic embolization was successfully used to control the bleeding. The management of this obstetrical complication and the use of this minimally invasive technique are also reviewed. To the best of our knowledge, this is the first report in the literature describing the feasibility of this technique in a patient with situs inversus totalis.

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Adenosquamous carcinoma of the bile duct treated with pancreaticoduodenectomy in a patient presenting situs inversus totalis: A case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2022.106767 ◽

2022 ◽

pp. 106767

Author(s):

Yoshito Wada ◽

Satoshi Taniwaki ◽

Hironobu So ◽

Tetsuo Imamura ◽

Yohsuke Morimitsu

Keyword(s):

Case Report ◽

Bile Duct ◽

Situs Inversus ◽

Adenosquamous Carcinoma ◽

Situs Inversus Totalis

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Incidental gallbladder carcinoma in regional Clinical Centre

Acta chirurgica iugoslavica ◽

10.2298/aci1002095m ◽

2010 ◽

Vol 57 (2) ◽

pp. 95-97 ◽

Cited By ~ 4

Author(s):

F. Mitrovic ◽

G. Krdzalic ◽

N. Musanovic ◽

H. Osmic

Keyword(s):

Survival Rate ◽

Gallbladder Cancer ◽

Gallbladder Carcinoma ◽

Open Cholecystectomy ◽

Squamous Carcinoma ◽

Radical Resection ◽

Significant Difference ◽

Clinical Centre ◽

Incidental Gallbladder Cancer ◽

Surgery Department

Background and Objectives: The aim of the study is to assess the characteristics, TNM stage and survival rate of incidental gallbladder carcinoma in patients who underwent open cholecystectomy in regional clinical centre. Patients and Methods: We retrospectively analyzed all consecutive cholecystectomies during four years period in surgery department and determined incidence, pathological stage and survival rate of incidental gallbladder cancer. Demographics data, surgical management, adjuvant therapy, death or last follow-up. We compared common characteristics and survival between pTis,1ab and pT2-3 groups of patients who underwent cholecytectomy alone. Results: Gallbladder carcinoma was diagnosed in 21 patients of 3007 cholecystectomies (0.69%). The most of patients had abdominal pain, cholelithiasis and fever. Postoperative pathology showed 20 adenocarcinomas and 1 squamous carcinoma. Seven cases were stage I, 7 stage II, 5 stage III. There was no patient in pT4 stage. The mean age was 60.6 ye-ars range (43-75). The 4 patients with pTis and 3 patients with pT1 had a 5-year survival rate of 100%. Patients with pT2-3 GBC had 5-year survival rate 8.34%. We noticed significant difference between those two cancer groups p<0.001. Conclusions: The incidence of incidental gallbladder cancer in this study was 0.69%. The pT-stage is very important factor in overall survival those patients. All cases of pT2-3 incidental GBC should be considered for extended radical resection after cholecystectomy alone.

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Case Reports of Situs Inversus Totalis and Dextrocardia in Sprague Dawley Rats

Veterinary Sciences ◽

10.3390/vetsci6030067 ◽

2019 ◽

Vol 6 (3) ◽

pp. 67

Author(s):

Reynaldo Oliva Hernández ◽

Jordan D. Lewicky ◽

Nya L. Fraleigh ◽

Hoang-Thanh Le

Keyword(s):

Situs Inversus ◽

Case Reports ◽

Health Sciences ◽

Situs Inversus Totalis ◽

Anatomical Location ◽

Sprague Dawley ◽

Vaccine Research ◽

Internal Organs ◽

Sprague Dawley Rats ◽

Congenital Condition

Situs inversus totalis is a condition where there is a transposition of all internal organs from their normal anatomical location. This infrequent and rare congenital condition has been described in several species of mammals. Dextorcardia is a series of conditions associated with an abnormal congenital positioning of the heart, and is often associated with situs inversus totalis. Here we report a case of situs inversus totalis and two cases of dextrocardia identified in Sprague Dawley rats during gross necropsy evaluations at both the Health Sciences North Research Institute (HSNRI) in Canada and Finlay Institute of Vaccine Research and Production in Cuba. The intent of this report is to share our findings and aid in the accumulation of data on these rare conditions.

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