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

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.