Gallbladder carcinoma manifesting as acute cholecystitis: Clinical and computed tomographic features

Liang, Jiun Lung; Chen, Min Chi; Huang, Hsuan Ying; Ng, Shu Hang; Sheen-Chen, Shyr Ming; Liu, Po Ping; Kung, Chia Te; Ko, Sheung Fat

doi:10.1016/j.surg.2009.04.037

Cited by 30 publications

(14 citation statements)

References 21 publications

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“…In addition, the appropriate extent of surgery cannot be intraoperatively determined, leading to poor prognoses (50). Surgeons are recommended to consider the possibility of GB cancer in patients who are suspected of having acute cholecystitis if they are older and exhibit focal GB wall thickening, a mass within the internal GB lumen, overall GB wall thickening with decreased GB size, or lymphadenopathy around the GB (51) (Level of evidence 4, Level of recommendation C).…”

Section: Surgical Treatment Of Gb Cancer Accompanied By Acute Cholecymentioning

confidence: 99%

Practical Guidelines for the Surgical Treatment of Gallbladder Cancer

Lee

Kim

et al. 2014

J Korean Med Sci

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At present, surgical treatment is the only curative option for gallbladder (GB) cancer. Many efforts therefore have been made to improve resectability and the survival rate. However, GB cancer has a low incidence, and no randomized, controlled trials have been conducted to establish the optimal treatment modalities. The present guidelines include recent recommendations based on current understanding and highlight controversial issues that require further research. For T1a GB cancer, the optimal treatment modality is simple cholecystectomy, which can be carried out as either a laparotomy or a laparoscopic surgery. For T1b GB cancer, either simple or an extended cholecystectomy is appropriate. An extended cholecystectomy is generally recommended for patients with GB cancer at stage T2 or above. In extended cholecystectomy, a wedge resection of the GB bed or a segmentectomy IVb/V can be performed and the optimal extent of lymph node dissection should include the cystic duct lymph node, the common bile duct lymph node, the lymph nodes around the hepatoduodenal ligament (the hepatic artery and portal vein lymph nodes), and the posterior superior pancreaticoduodenal lymph node. Depending on patient status and disease severity, surgeons may decide to perform palliative surgeries.Graphical Abstract

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Section: Surgical Treatment Of Gb Cancer Accompanied By Acute Cholecymentioning

confidence: 99%

Practical Guidelines for the Surgical Treatment of Gallbladder Cancer

Lee

Kim

et al. 2014

J Korean Med Sci

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“…For elderly patients, especially women, presenting with acute cholecystitis and abnormal liver function, CT demonstration of focal gallbladder wall thickening, intraluminal masses, small gallbladder with diffuse wall thickening, and enlarged regional lymph nodes are suggestive of concurrent GBC. [4041]…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and management of gallbladder cancer

Andrén‐Sandberg¹

2012

North Am J Med Sci

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“…18 Most of the polyploid masses in this series were not dif-ficult to diagnose, with a mean size of 37 mm. However, the one case that was not prospectively identified was a small T1 lesion in a patient with acute abdominal pain, no symptoms suggestive of malignancy, and a presumptive diagnosis of cholecystitis.…”

Section: Discussionmentioning

confidence: 62%

Features Suggestive of Gallbladder Malignancy

Mitchell

Johnson²,

Fishman³

et al. 2014

Journal of Computer Assisted Tomography

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Objectives Gallbladder cancer carries an extremely high mortality rate, with a 5-year survival rate as low as 12%. Survival is dependent on the diagnosis of these tumors in their earliest stages. This study sought to describe the clinical and imaging features of stages T1, T2, and T3 gallbladder tumors and to illustrate features that may allow radiologists to make an early diagnosis. Materials and Methods After approval from the institutional review board, a search of the pathology department database yielded 18 patients with surgically proven T1, T2, and T3 gallbladder cancers with available preoperative computed tomography (CT) or magnetic resonance imaging. The imaging was reviewed for lesional morphology (focal polyploid mass, focal wall thickening, circumferential wall thickening), enhancement characteristics, liver invasion, locoregional lymph-adenopathy, and distant metastatic disease. The electronic medical record was also searched for demographic information and clinical presentation. Results There were 10 women and 8 men with a mean age of 69 years. Virtually all patients were symptomatic, with most patients demonstrating symptoms suggestive of underlying malignancy (including jaundice, weight loss, and chronic abdominal pain). Tumors on CT and MRI included 6 polyploid masses, 9 tumors with focal wall thickening, and 3 with circumferential wall thickening. The mean attenuation of those tumors imaged with CT was 59.4 Hounsfield units (HUs) on the arterial phase and 86.5 HUs on the venous phase, with a mean increase in Hounsfield attenuation between the arterial and venous phases of 28.2 HUs. Twelve of the 18 patients were correctly diagnosed prospectively on CT. Conclusions The imaging findings of gallbladder cancer can be subtle, regardless of whether the tumor presents as a discrete mass, focal wall thickening, or circumferential diffuse wall thickening, and radio-logists should be aware of the wide range of different possible appearances. Moreover, the vast majority of these patients had clinical symptoms suggestive of an underlying malignancy, and this should precipitate a careful evaluation of the gallbladder in all such cases.

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Gallbladder carcinoma manifesting as acute cholecystitis: Clinical and computed tomographic features

Cited by 30 publications

References 21 publications

Practical Guidelines for the Surgical Treatment of Gallbladder Cancer

Practical Guidelines for the Surgical Treatment of Gallbladder Cancer

Diagnosis and management of gallbladder cancer

Features Suggestive of Gallbladder Malignancy

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