Gallbladder Carcinoma: Radiologic-Pathologic Correlation

Abstract

Primary carcinoma of the gallbladder is an uncommon, aggressive malignancy that affects women more frequently than men. Older age groups are most often affected, and coexisting gallstones are present in the vast majority of cases. The symptoms at presentation are vague and are most often related to adjacent organ invasion. Therefore, despite advances in cross-sectional imaging, early-stage tumors are not often encountered. Imaging studies may reveal a mass replacing the normal gallbladder, diffuse or focal thickening of the gallbladder wall, or a polypoid mass within the gallbladder lumen. Adjacent organ invasion, most commonly involving the liver, is typically present at diagnosis, as is biliary obstruction. Periportal and peripancreatic lymphadenopathy, hematogenous metastases, and peritoneal metastases may also be seen. The vast majority of gallbladder carcinomas are adenocarcinomas. Because most patients present with advanced disease, the prognosis is poor, with a reported 5-year survival rate of less than 5% in most large series. The radiologic differential diagnosis includes the more frequently encountered inflammatory conditions of the gallbladder, xanthogranulomatous cholecystitis, adenomyomatosis, other hepatobiliary malignancies, and metastatic disease.

Impact of Routine Histopathological Examination of Gall Bladder Specimens on Early Detection of Malignancy - A Study of 4,115 Cholecystectomy Specimens

“…On ultrasonography (USG) examination, 40-60% cases can be detected only when there is a solid intraluminal mass (Levy et al, 2001). Diffuse wall thickening is a non specific finding as it is seen in chronic inflammatory condition as well.…”

Computed Tomographic Findings in 50 Cases of Gall Bladder Carcinoma

“…The wall thickening showed enhancement on contrast administration. GB carcinoma presenting with focal or diffuse mural thickening is usually the least common presentation [1,2] and is often difficult to diagnose as GB wall thickening is seen in wide range of clinical settings such as chronic cholecystitis, adenomyomatosis, inadequate GB distension, hepatitis and low protein states [1,9]. The wall is usually 4 -13 mm in thickness and is often asymmetrically thickened and nodular [2].…”

“…CT is superior for evaluating the morphology of portions of GB wall that are obscured by gallstones or mural calcifications on ultrasound [9]. CT is better than ultrasound for detecting lymphadenopathy, especially for N2 nodal stage [3].…”

Overweight, obesity and the risk of gallbladder and extrahepatic bile duct cancers: A meta‐analysis of observational studies

“…GBC is the most common biliary tract neoplasm and the sixth most common cancer in the gastrointestinal tract (16,17). It is typically characterized by late diagnosis and poor outcome with a 5-year survival of 32% (18).…”