Bazan et al. Journal of Medical Case Reports 2011, 5:458 http://www.jmedicalcasereports.com/content/5/1/458 recognize the origin of the primary tumor in order to optimize treatment. The proliferation of signet-ring cells in gallbladder adenocarcinoma worsens the patient’s prognosis. With only a few cases reported and an apparently ineffective classic line of treatment, we believe that more research about the biology of this cell line should be encouraged in order to modify the chemotherapy or to add biologi- cal therapy. Consent Written informed consent was obtained from the patient’s next-of-kin for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Acknowledgements The authors would like to thank Sònia Gayete Lafuente who collaborated in the writing and translation of the manuscript. Author details 1Department of Radiology, Parc de Salut Mar Hospital, Barcelona, Cataluña, Spain. 2Department of Pathology, Parc de Salut Mar Hospital, Barcelona, Cataluña, Spain. Authors’ contributions FB, JS, GA, AR, MB and FZ have made substantial contributions to the conception, design, acquisition and interpretation of data; LP performed the histological examination of the gallbladder; NR has been involved in drafting the manuscript and revising it critically for important intellectual content. All authors read and approved the final manuscript. Competing interests The authors declare that they have no competing interests. Received: 28 January 2011 Accepted: 14 September 2011 Published: 14 September 2011 References 1. Misra S, Charturvedi A, Misra NC, Sharma ID: Carcinoma of the gallbladder. Lancet Oncol 2003, 4:167-176. 2. 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