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PRIMARY GALLBLADDER CARCINOMA
Category: Diagnostic Radiology
Abstract : Primary gallbladder carcinoma Cancer of the gallbladder is usually associated
with gallstones and a history of cholecystitis. Most often, the gallbladder
lumen is occupied by a solid mass which may have the appearance of a large
polyp. The wall appears thickened and irregular and shadowing from the stones
may obscure it posteriorly. A bile-filled lumen may be absent, further
complicat
Primary gallbladder carcinoma
Cancer of the gallbladder is usually associated
with gallstones and a history of cholecystitis. Most often, the gallbladder
lumen is occupied by a solid mass which may have the appearance of a large
polyp. The wall appears thickened and irregular and shadowing from the stones
may obscure it posteriorly. A bile-filled lumen may be absent, further
complicating the ultrasound diagnosis.
In a porcelain gallbladder
(calcification of the gallbladder wall), which is associated with gallbladder
carcinoma, the shadowing usually obscures any lesion in the lumen, making the
detection of any lesion present almost impossible.
Particular risk
factors for gallbladder carcinoma include large stones, polyps of over 1 cm in
size, porcelain gallbladder and, occasionally, choledochal cyst due to anomalous
junction of the pancreatobiliary ducts.
The carcinoma itself is
frequently asymptomatic in the early stages, and patients tend to present with
symptoms relating to the stones. It is a highly malignant lesion which quickly
metastasizes to the liver and portal nodes and has a very poor prognosis, with a
curative surgical resection rate of around 15–20%.
Doppler may assist in
differentiating carcinoma from other causes of gallbladder wall thickening, but
further staging with CT is usually necessary. Ultrasound may also demonstrate
local spread into the adjacent liver.
Hit: 204 times
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