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Incidental gallbladder carcinoma in regional Clinical Centre
Mitrovi？ F.,Krd？ali？ G.,Musanovi？ N.,Osmi？ H.
Acta Chirurgica Iugoslavica , 2010, DOI: 10.2298/aci1002095m
Abstract: Background and Objectives: The aim of the study is to assess the characteristics, TNM stage and survival rate of incidental gallbladder carcinoma in patients who underwent open cholecystectomy in regional clinical centre. Patients and Methods: We retrospectively analyzed all consecutive cholecystectomies during four years period in surgery department and determined incidence, pathological stage and survival rate of incidental gallbladder cancer. Demographics data, surgical management, adjuvant therapy, death or last follow-up. We compared common characteristics and survival between pTis,1ab and pT2-3 groups of patients who underwent cholecytectomy alone. Results: Gallbladder carcinoma was diagnosed in 21 patients of 3007 cholecystectomies (0.69%). The most of patients had abdominal pain, cholelithiasis and fever. Postoperative pathology showed 20 adenocarcinomas and 1 squamous carcinoma. Seven cases were stage I, 7 stage II, 5 stage III. There was no patient in pT4 stage. The mean age was 60.6 ye-ars range (43-75). The 4 patients with pTis and 3 patients with pT1 had a 5-year survival rate of 100%. Patients with pT2-3 GBC had 5-year survival rate 8.34%. We noticed significant difference between those two cancer groups p<0.001. Conclusions: The incidence of incidental gallbladder cancer in this study was 0.69%. The pT-stage is very important factor in overall survival those patients. All cases of pT2-3 incidental GBC should be considered for extended radical resection after cholecystectomy alone.
Incidental non-benign gallbladder histopathology after cholecystectomy in an United Kingdom population: Need for routine histological analysis?
Asif Jah,Emmanuel L Huguet,Khaled Dajani,Krashna Patel,Nikolaos A Chatzizacharias,Prateush Singh,Raaj K Praseedom,Rebecca Brais,Saranya Vickramarajah,Satheesh Iype,Simon Harper,Siong S Liau,Susan Davies
- , 2016, DOI: 10.4240/wjgs.v8.i10.685
Abstract:
Unexpected gallbladder cancer
Cortés Armando,Botero María Paula,Carrascal Edwin,Bustamante Fabio
Colombia Médica , 2004,
Abstract: Background. Gallbladder cancer is a relatively uncommon malignancy in Colombia. To establish the overall rate of gallbladder carcinoma and unexpected gallbladder Study design and methods. We retrospectively evaluate all consecutive cholecystectomies performed in the Fundación Hospital San José de Buga during a 2 year-old period to determine the incidence of carcinoma of the vesicle and to identify retrospectively characteristic common in this particular group of patient. Results. Of the 376 cholecystectomies performed in this hospital during the last two years, the carcinoma of gallbladder was diagnosed in six patients alone in one of them was suspected before the surgery. In accordance with the literature, the occurrence in women (83.3%) was higher than in men (16.7%). The mean age was 58.5 years (range 41±71). Its presentation is similar to that of lithic disease of the gallbladder. The most common symptom is was abdominal pain; the majority (66.7%) had cholelithiasis, and the pathological reports confirm the diagnosis adenocarcinoma in all the six patients. Conclusions. The overall incidence of unsuspected gallbladder carcinoma in our series was 1.6%. We could not find common characteristic for this particular group of patient when compared to patients with no-malignant pathology. Gallbladder cancer was undiagnosed for clinical physician, radiologist, surgeon and pathologist for examination macroscopic specimens.
Multiple port-site metastasis of incidental gallbladder carcinoma after laparoscopic cholecystectomy
Ra？natovi？ Zoran J.,Zari？ Nemanja D.,Galun Danijel A.,Leki？ Neboj？a S.
Acta Chirurgica Iugoslavica , 2012, DOI: 10.2298/aci1201105r
Abstract: Laparoscopic cholecystectomy is a surgical procedure of choice for benign gallbladder diseases. In about 1-2% of cases histopathological examination demonstrate incidental gallbladder cancer (GBCA). We report a case of a 61 year old woman who developed port site metastases after laparoscopic cholecystectomy for adenocarcinoma of the gallbladder. Metastases appeared on all four port sites. Review of literature regarding incidental GBCA an port site metastases was also performed. We conclude that the retrieval bag should be routinely used in laparoscopic cholecystectomy; the procedure should be performed with minimal trauma; in cases of incidental GB carcinoma, full thickness excision of the abdominal wall of the port sites demands additional studies; additional liver bed excision and local lymphadenectomy for T1b carcinoma are yet to be considered.
Gallbladder Carcinoma of the Thyroid Revealed by an Acute Festered Thyroiditis: A Literature Study about a Case  [PDF]
Aliou Faty, Hady Tall, Abdou Sy, Fulgence Abdou Faye, Birame Loum, Kevin Dimitri Manfoumbi Manfoumbi
International Journal of Otolaryngology and Head & Neck Surgery (IJOHNS) , 2023, DOI: 10.4236/ijohns.2023.123014
Abstract: The cutaneous extension of gallbladder thyroid carcinoma is uncommon and is among the aggressive forms of the disease. We are reporting the case of a woman of 54 that shows acute festered thyroiditis worsened by a necrotic ulcer wound on the skin lasting 3 weeks amid a big neglected hetero-multinodular goitre, evolving since 20 years. The anatomopathological test showed a gallbladder thyroid carcinoma of the thyroid with severe inflammation. The treatment consisted of a complete thyroidectomy with recurrent bilateral dredging. There was a favourable evolution. Gallbladder carcinoma, in its aggressive aspect, may be linked to the occurrence of acute festered thyroiditis. Therefore, the prognosis of our patient was favourable.
隐匿性胆囊癌的病理学分析
韩扬,徐安安,符雪莲,顾俊毅,宋艳祥,王军臣
- , 2017, DOI: 10.16118/j.1008-0392.2017.02.009
Abstract: 目的 分析隐匿性胆囊癌的病理学特点及P53、CEA和Ki67等在其鉴别诊断用的应用价值。方法 回顾性分析55例隐匿性胆囊癌的临床表现、巨检特征、组织学特点和预后等,分析肿瘤标志物P53,CEA和Ki67在鉴别诊断中的价值。结果(1) 本组隐匿性胆囊癌55例,发生率为0.40%(55/15042)。男女比例2∶3,年龄34~85岁,中位年龄65岁。(2) 肉眼观,见胆囊增大,囊壁局限性增厚,平均厚度0.9cm;或呈囊状扩张,或与正常胆囊无明显差别,亦可见孤立性息肉样病变。所有胆囊均可见黏膜粗糙,31例患者伴有胆囊结石。镜下4例为乳头状管状腺瘤癌变,肿瘤与周围组织截然分界,6例为黏膜内癌伴微浸润,3例为黏膜内癌,肿瘤与周围组织有过度并可见胆道上皮内瘤变,10例为囊内乳头状肿瘤伴浸润性癌,其余32例为浸润性癌,其中普通型腺癌28例,黏液腺癌2例,鳞状细胞癌1例,印戒细胞癌1例。(3) 本组P53和CEA在不同类型的肿瘤中具有差异性表达。P53在38.7%(12/31)的胆囊浸润性腺癌中强表达,而在形成罗-阿窦的腺体表达阴性；CEA在61.3%(19/31)的胆囊浸润性腺癌中强表达,在周围正常黏膜上皮和罗-阿窦的腺体中表达阴性；同样Ki67增殖指数在浸润性癌中明显高于黏膜内癌和囊内乳头状肿瘤。(4) 本组50例获得随访资料,随访时间1~71个月,平均随访27.4个月,6例患者出现复发和肝脏转移,14例患者死亡,中位生存时间35.6个月。结论 隐匿性胆囊癌的发病率极低,好发于老年女性患者,绝大多数伴有胆囊结石。肉眼观病变局限,腺癌是最主要的组织学类型,其次为伴有浸润的囊内乳头状肿瘤。P53,CEA和Ki67有助于评判异型腺体的浸润深度和对鉴别肿瘤性腺体浸润、罗-阿窦形成和胆囊腺肌症有重要意义。大部分IGC临床分期较早,单纯手术切除能达到预期效果,TNM分期和高Ki67增殖指数是影响其预后的主要的因素。
ObjectiveTo analyze the clinical and pathological features in incidental gallbladder cancers. detected after laparoscopic cholecystectomy. Methods In 15042 laparoscopically resected samples, preoperatively undiagnosed gallbladder cancer was detected by pathological examination in 52 cases (0.40%). The clinical and pathological features of 52 cases of incidental gallbladder carcinoma (IGC) were retrospectively analyzed. The expressions of P53, CEA and Ki67 in tissue samples were detected by immunohistochemistry EnVison method. Results Among 52 IGC cases, the male to female ratio was 2∶3 and the mean age was 65 years (34 to 85). Macroscopically, the gallbladders were enlarged with focally thicken wall or dilated with cysts with an average thickness of 0.9cm; solitary polyp was also found; gallbladder stone was detected in 31 cases. Microscopically there were 4 cases of papillary-tubular adenoma with high grade intraepithelial neoplasm and focal invasive adenocarcinoma; 3 cases of intramucosal carcinoma and 6 cases of microinvasive adenocarcinoma with biliary intraepithelial neoplasia (BiIN) adjacent the tumor; 32 cases of invasive carcinoma including invasive adenocarcinoma, mucinous carcinoma, squamous cell carcinoma and signet ring cell carcinoma. P53 was expressed in 38.7% (12/31) invasive adenocarcinoma, while it was negative expressed in R-A glands. CEA was expressed in 61.3% (19/31) invasive adenocarcinoma, while it was negative expressed in R-A glands and the adjacent mucus. Ki67 index was higher in invasive adenocarcinoma than intramucous carcinoma and intracyctic papillary neoplasm (ICPN). Among 50 patients who were followed up for 1 to 71 months, 6 patients relapsed with liver metastasis, 14 patients died during the following up. The middle
Improved Outcomes in Gallbladder Cancer with Early Diagnosis and Negative Nodal Status  [PDF]
Lauren Smithson, Christopher Keto, Lorenzo Ferguson, Sumet Silapaswan, Michael J. Jacobs, Ramachandra Kolachalam, Jeffrey C. Flynn, Vijay K. Mittal
Journal of Cancer Therapy (JCT) , 2012, DOI: 10.4236/jct.2012.32019
Abstract: Background: Gallbladder cancer (GBC) is a rare disease of the hepatobiliary tract characterized by silent presentation, poor prognosis, and limited therapy. Current imaging modalities, clinical symptoms and laboratory values are of limited value in diagnosis and tumour markers are used as a clinical adjunct. Five year survival is 5% - 12% and a majority of patients survive less than 1 year. Early identification, negative nodal status, and extended cholecystectomy improve survival; adjuvant therapy does not appear to play a role. Objective: To evaluate the effects of stage and nodal status of GBC on survival by analyzing clinical and radiological factors leading to preoperative diagnosis and appropriate subsequent management. Results: Forty-three patients (31 female, 12 male) had primary GBC. Average age was 69 years. The most common presenting symptom was pain (65%). Fifteen (35%) patients presented with acute cholecystitis; 9 were suspicious for a mass. Ultrasound and computed tomography were the imaging modalities most often used. Preoperative diagnoses were made in only 7 (16%) patients, whereas 16 (37%) patients were diagnosed intra-operatively and 20 (47%) post-operatively. Adjuvant chemotherapy was offered in 16 (37%) patients. Average survival was 28 months (range 0.5 - 238 months), with a 5-year survival of 13% across all stages. Early GBC (stages 1 - 2) had a 5-year survival of 43%, and late GBC (stages 3 - 4) had no survival at 5 years, with an average survival of 9 months. Positive nodes decreased survival. Conclusion: Our results mirror what has been reported in the literature. Most patients presented with acute cholecystitis, with confounding clinical data, but few were preoperatively diagnosed with GBC. Imaging was rarely diagnostic. Late stage GBC, as well as node-positive status, had dismal outcomes with low 1-year and 5-year survival rates. Improved preoperative suspicion of early GBC would allow for more intentional curative resections, before nodes become positive.
Primary Pure Squamous Cell Carcinoma of the Gallbladder: Case Report  [PDF]
Sharique Nazir, Muhammad Rauf, Ibrahim Jabbour, Jacques Duperval, Armand Asarian, Fatima Shaikh, Philip Xiao, Peter Pappas
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.38083
Abstract: Squamous cell carcinoma of the gallbladder is rare and accounts for about 12.7% of all cases of gallbladder cancer. Pure squamous cell carcinoma is even less common with a reported incidence of 3.3%. We present a case of 72 year-old African-American woman with decreased appetite, fatigue, and weight loss associated with intermittent right upper quadrant pain for two months. Computed tomography of the abdomen revealed a mass in the gallbladder and the hepatic flexure of the colon with involvement of adjacent small bowel. On exploratory laparotomy, a mass at the dome of the gallbladder was found with local invasion of the hepatic flexure, and the proximal transverse colon. There was no obvious involvement of the duodenum, common bile duct, or the extra-hepatic biliary tree. An extended right hemicolectomy, distal small bowel resection, cholecystectomy, a wedge resection of the liver and a feeding jejunostomy, were performed. Pathologic evaluation demonstrated well to moderately differentiated squamous cell carcinoma of gallbladder without evidence of distant metastasis. The patient improved clinically and was discharged home in good condition.
Role of Combination Chemotherapy with 5-Fluorouracil, Cisplatin and Paclitaxel for Advanced Gall Bladder Cancer  [PDF]
Mumtaz Ahmad Ansari, Satyendra K. Tiwary, Uday Pratap Shahi, Vijay K. Shukla
Journal of Cancer Therapy (JCT) , 2014, DOI: 10.4236/jct.2014.53032
Abstract:

Aim: The prognosis for patients with advanced Gallbladder carcinoma is poor. Due to unresectability and relatively ineffective chemotherapy available, a need exists for effective chemotherapeutic regimen. The aim of this study was to determine the efficacy and safety profile of 5-fluorouracil, cisplatin and paclitaxel in patients with advanced Gallbladder cancer. Material and Methods: From January 2002 to July 2004, 40 patients of advanced carcinoma Gallbladder received 5-fluorouracil, cisplatin and paclitaxel. On day 1, paclitaxel was given (150 mg/m2), cisplatin was given on day 2 (50 mg/m2) and 5-fluorouracil was given from day 1 to day 3 (500 mg/m2). This cycle was repeated every three weeks and patient assessment was done. Results: Forty patients were enrolled in this study. Thirty-five were assessed for response. Five patients were lost in follow up. There were thirty females and ten males. A median of three cycles of treatment (range one to seven) was administered. Two patients achieved complete response and eleven had partial responses giving an overall response rate of 32.5% in the intention-to-treat population (95% confidence interval 11.1% to 46.5%). The median response duration was 5.3 months. The median time to progression and overall survival was 4.1 months and 11.2

Gallbladder Diseases
Opa？i？, Milorad
- , 2006,
Abstract: Sa？etak This topic review summarizes epidemiology, the clinical signifi cance, diagnostic tests and therapeutic approach in patients with diseases of the gallbladder. Special attention is given to the diagnostic procedures and treatment options for patients with symptomatic gallstones, cholecystitis, gallbladder polyps and gallbladder carcinoma
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