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07 muts/Mb were detected in the tubular component. This patient died of tumor recurrence 2 months after the surgery. Conclusions The undifferentiated gallbladder carcinoma had its unique molecular alterations. The similarities in the genetic alterations of the undifferentiated carcinoma and adenocarcinoma provide evidence of a common origin at the genetic level. The occurrence of an undifferentiated carcinoma may be due to heterogeneity-associated branched evolution from the tubular adenocarcinoma.The gut microbiome regulates a number of homeostatic mechani