Squamous Cell Carcinoma of the Gallbladder With Recurrence at the Tumor Spillage Site Following Laparoscopic Cholecystectomy

Squamous cell carcinoma of the gallbladder is a rare and aggressive biliary malignancy, typically associated with locally invasive disease and poor outcomes, whereas most gallbladder cancers are adenocarcinomas staged primarily by depth of invasion. We report the case of a 76-year-old woman who presented with acute calculous cholecystitis and choledocholithiasis and underwent laparoscopic cholecystectomy followed by endoscopic retrograde cholangiopancreatography. During cholecystectomy for a severely inflamed and friable gallbladder, intraoperative gallbladder perforation with bile and gallstone spillage occurred. Final histopathology revealed a moderately differentiated squamous cell carcinoma of the gallbladder, pathological stage T1, confined to the lamina propria with negative surgical margins. Despite favorable initial staging, follow-up imaging at three months demonstrated local recurrence within the gallbladder fossa and peritoneal dissemination in the right paracolic gutter, consistent with early tumor recurrence. This case highlights the aggressive biological behavior of gallbladder squamous cell carcinoma and underscores the potential role of operative factors, including tumor spillage, in early recurrence despite apparently early-stage disease.