Carcinoma of the gallbladder: A clinical and pathologic study

Abstract

Carcinoma of the gallbladder occurs most frequently in the fifth decade of life and is predominantly a disease of women. Stones were associated with the carcinoma in 88 per cent of cases and that they definitely preceded the development of the carcinoma was evident in 58.5 per cent of these cases. An analysis of the early symptoms revealed nothing which could not be attributed to the presence of chronic inflammation of the gallbladder with or without cholelithiasis. The classification of these carcinomas was adenocarcinoma, 85.3 per cent; squamous cell carcinoma, 2.7 per cent, and adeno-carcinoma, 12.0 per cent. Three instances of malignant degeneration in a papilloma and one in an adenoma were found. The finding of areas of metaplasia in the mucosa and of adenocarcinoma and squamous cell carcinoma in the same tumor lends support to the theory of metaplasia for the origin of a squamous cell carcinoma. Five-year cures were obtained in 45 per cent of the cases of carcinoma, grade 1, in 4.3 per cent in cases of grade 2 and in none of the cases of carcinoma of the other grades. In no instance was a definite diagnosis made preoperatively.