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Shui XL, Liu YF. Intraoperative frozen section diagnosis of primary alpha-fetoprotein–positive hepatoid adenocarcinoma of the gallbladder: A case report. World J Gastrointest Surg 2026; 18(11): 124589 [DOI: 10.4240/wjgs.124589]
World J Gastrointest Surg. Nov 27, 2026; 18(11): 124589 Published online Nov 27, 2026. doi: 10.4240/wjgs.124589
Intraoperative frozen section diagnosis of primary alpha-fetoprotein–positive hepatoid adenocarcinoma of the gallbladder: A case report
Xiao-Li Shui, Yu-Fei Liu
Xiao-Li Shui, Yu-Fei Liu, Institute of Pathology, China Three Gorges University, Yichang 443003, Hubei Province, China
Xiao-Li Shui, Yu-Fei Liu, Department of Pathology, Affiliated Central People’s Hospital, China Three Gorges University, Yichang 443003, Hubei Province, China
Author contributions: Shui XL and Liu YF contributed to conceptualization, data curation, investigation, visualization, and writing-original draft; Liu YF contributed to formal analysis, project administration, and writing-review and editing.
AI contribution statement: All clinical data, analyses, and conclusions were completed, reviewed, and revised by the authors. AI was not involved in data acquisition, clinical analysis, or interpretation of the results.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Yu-Fei Liu, Department of Pathology, Affiliated Central People’s Hospital, China Three Gorges University, No. 183 Yiling Boulevard, Wujiagang District, Yichang 443003, Hubei Province, China. lyf780579@163.com
Received: June 22, 2026 Revised: August 5, 2026 Accepted: September 28, 2026 Published online: November 27, 2026 Processing time: 146 Days and 19 Hours
Abstract
BACKGROUND
This study explored the key points of intraoperative frozen pathological diagnosis and the clinical diagnostic value of primary alpha-fetoprotein (AFP)-positive hepatoid adenocarcinoma of the gallbladder (HAGB).
CASE SUMMARY
The clinical data, imaging findings, intraoperative frozen pathology, postoperative routine pathology, and immunohistochemical findings of a 61-year-old patient with AFP-HAGB admitted in 2023 were analyzed. Relevant literature was also reviewed. The patient was admitted because of a gallbladder mass detected during a physical examination, with significantly elevated serum AFP. The intraoperative frozen section showed typical hepatoid differentiation of the tumor, suggesting HAGB. Postoperative pathology and immunohistochemistry confirmed AFP-HAGB accompanied by lymph node metastasis. The patient’s condition stabilized after surgical treatment.
CONCLUSION
Intraoperative frozen pathology can rapidly and accurately identify AFP-HAGB. Combined with serum AFP, imaging, and immunohistochemistry, a clear diagnosis can be made, which is of significant clinical importance for guiding surgical decisions and reducing misdiagnosis.
Core Tip: Intraoperative frozen section pathology combined with serum alpha-fetoprotein, imaging, and immunohistochemistry enables rapid and accurate diagnosis of primary alpha-fetoprotein-positive hepatoid adenocarcinoma of the gallbladder, which is crucial for guiding intraoperative surgical decisions and reducing misdiagnosis.
