A CASE REPORT OF A TYPHOID CARRIER WITH EARLY GALLBLADDER CANCER

Abstract

This is a case report of a 74-year-old female typhoid carrier with history of typhoid fever 45 years earlier. When her granddaughter was suffered from sepsis caused by Salmonella typhi, she was tested and found to be a typhoid carrier. On further investigations, a complicating cholecystolithiasis was detected. Another lesion, an early gallbladder cancer located in the mucosal layer, was found at the time of cholecystectomy for radical therapy. On histopathological study, infiltration of inflammatory cells and marked intestinal metaplasia were observed in the cancerous and the noncancerous regions of the gallbladder. Since it is well known that complicating cholelithiasis is usually seen in typhoid carriers who have discharged the bacteria for a long time, we studied the relationship between cholelithiasis and gallbladder cancer in typhoid carriers. Gallbladder cancer was found in 9.4% of patients treated by cholecystectomy for the purpose of complete cure. Deaths from cancer of the hepatobiliary system accounted for 5.9% of all deaths of typhoid carriers. Furthermore, the ratio of cancer deaths among carriers with cholelithiasis was significantly higher than that among carriers without cholelithiasis. On the basis of these facts, for carriers who have a complicating cholelithiasis, we must make prudent plans for treatment and examination, considering the possibility of a complication such as cancer of the hepatobiliary system including gallbladder cancer.