Incidental Gallbladder Carcinoma Research Articles

Incidental gall bladder carcinoma after cholecystectomy for benign disease: An institutional experience

Cholecystectomy is the most common routinely performed procedure for benign gallbladder disease worldwide and incidental gall bladder cancer is mostly detected in post-cholecystectomy specimens.This retrospective study emphasizes on the need for routine surveillance of post-cholecystectomy specimens by evaluating the incidence of incidental findings of carcinoma in cholecystectomy specimens done for benign gallbladder disease.A total of 2443 patients were evaluated over a period of 7 years, out of which, 18 patients were diagnosed with incidental gall bladder carcinoma with an incidence of 0.73 %. The mean age of affected patients was 59 years. Among the 18 patients, 8 patients (44 %) had an intra-operative suspicion of malignancy. Once incidental cancer is detected the treatment decision should be decided according to tumor spread and depth as well as the patient's age, additional health problems, and life expectancy.

Incidentally Detected Gallbladder Carcinoma: Can F-18 FDG PET/CT Aid in Staging and Prognostication?

Incidental gallbladder carcinoma (IGBC) is diagnosed in post-cholecystectomy specimens for benign indications, where the role of 2-fluro-2-deoxyglucose positron emission tomography/computed tomography(FDG-PET/CT) is not clearly defined. The present study aimed to assess the benefits of staging and prognosticating with FDG-PET/CT in IGBC. A retrospective observational study from a tertiary-care center from January 2010 to July 2020 was performed. The demographic, clinical, histopathological, and treatment-related histories were collected. FDG-PET/CT-image findings were compared with survival outcomes through telephonic follow-up. The chi-square test was used for comparing frequencies. The univariate and multivariate survival estimates were analyzed using the Kaplan-Meier analysis and the Cox-proportional hazard model, respectively. Log-rank test was used to compare the Kaplan-Meier curves. The study included 280 postcholecystectomy participants (mean age: 52 ± 11years; women: 227) of whom 52.1% had open surgery(146/280). Residual disease in the gallbladder fossa (54.8% vs. 36.6%, p = 0.002) and liver infiltration (32.9% vs. 22.4%, p = 0.05) were seen more frequently in open surgery compared to laparoscopic surgery, while anterior abdominal wall deposits were more common in laparoscopy(35.1% vs. 24%,p = 0.041). FDG-PET/CT changed the management in 10% (n = 28) of patients compared to contrast-enhanced CT. The median survival was 14months (95%CI-10.3-17.7). A higher stage of the disease on the FDG-PET/CT (loco-regional disease-HR 4.86, p = 0.006; metastatic disease-HR 7.53, p < 0.001) and the presence of liver infiltration (HR-1.92, p = 0.003) were independent predictors of poor survival outcomes. FDG-PET/CT detects residual and metastatic disease in patients with IGBC, enabling the institution of appropriate management and acting as a tool for prognostication of survival.

Robotic bi-segmentectomy and hilar lymphadenectomy for incidental gallbladder carcinoma – a case series

Robotic bi-segmentectomy and hilar lymphadenectomy for incidental gallbladder carcinoma – a case series

Incidental precancerous and cancerous neoplasms in routine cholecystectomy specimens – A fascinating series of cases in a tertiary care center

Laparoscopic cholecystectomy is one of the most commonly performed surgeries for benign gall bladder pathologies. Pre-cancerous and malignant gall bladder neoplasms often have overlapping non-specific clinical manifestation in their early stages. Radiological findings are also non-specific in the early stages with the presence of cholelithiasis in a significant proportion of cases. Cholelithiasis is said to be one of the important comorbid risk factors for gall bladder carcinoma (GBC) as a source of constant irritation to biliary mucosa. In such cases, cholecystectomy done for benign indications may lead to a histopathological diagnosis of incidental gall bladder carcinomas. Pancreaticobiliary type of adenocarcinoma is the most common subtype of GBC with two described cases in this series. Invasive foci need to be ruled out in. All cases of high-grade biliary intraepithelial neoplasia as were seen in the third case. Intracholecystic papillary neoplasm is a recently described entity with one reported case in this series that was associated with invasive adenocarcinoma. Signet ring adenocarcinoma is a rarely encountered adenocarcinoma in gall bladder with worse outcome. One such case has been described here where the patient has succumbed to death within 3 months of surgery and during the course of adjuvant therapy.

Incidental Finding of Gall Bladder Carcinoma in Post-Menopausal Females in Cholecystectomy Specimen

Objective: To highlight the significance of histopathological examination of gallbladder and to evaluate incidental gallbladder cancer in post-menopausal females. Study Design: Cross-sectional Study. Place and Duration of Study: Department of Pathology, Diagnostic and Research Laboratory, Liaquat University of Medical and Health Sciences, Hyderabad Pakistan, from Jan 2020 to Dec 2021. Methodology: Two thousand nine hundred fifty-nine (n=2959) gallbladder specimens with a clinical diagnosis of cholelithiasis and cholecystitis were analyzed. The clinical history of patients was taken from computer storage data. Results: Out of the total 2959 cases, on histopathological examination, chronic cholecystitis was the commonest finding (1990, 67.25%), followed by acute cholecystitis 410(13.85%) cholesterolosis (396,13.38%) and gallbladder carcinoma 42(1.42%). Out of 42 cases of gallbladder carcinoma, 34(80.95%) were female and 8(19%) were male. Most cases were post-menopausal age group 21(61.76%) compared to premenopausal 13(38.23%).Conclusion: In our study, Incidental gallbladder carcinoma in post-menopausal women was higher than expected.

Incidental gallbladder carcinoma in routine cholecystectomy specimens at tertiary care hospital

Incidental gallbladder carcinoma in routine cholecystectomy specimens at tertiary care hospital

107P Comprehensive genomic profiling of “The German-registry of incidental gallbladder carcinoma” cases

107P Comprehensive genomic profiling of “The German-registry of incidental gallbladder carcinoma” cases

Can the sampling method affect the detection of incidental gallbladder carcinoma? Comparative analysis of two sampling methods

Gallbladder cancer (GBC) is the most common biliary tract carcinoma and is commonly diagnosed incidentally in cholecystectomies performed for gallstones. GBC are mostly unrecognizable macroscopically, and sampling is therefore import. This single center study aimed to find out the effect of sampling method on the identification rate of incidental GBC by comparing random sampling and longitudinal full-thickness slice sampling, which was developed in high-incidence areas. A hospital electronic database was searched for cholecystectomy specimens submitted to the pathology department between 01/2000 and 03/2016. Cases with a preoperative clinical and/or radiological suspicion of neoplasia and cases with a macroscopically identified mass were excluded from the study. Two groups were formed according to the sampling method: “random sampling” group (Group 1, n = 10,954) and “full-thickness slice sampling” group (Group 2, n = 5254). In the first group, random samples from the fundus, body and neck were submitted in gallbladders without grossly visible pathology. In the second group, a full-thickness slice sampling protocol was performed, wherein a longitudinal full-thickness slice, including fundus, corpus-neck and the cystic duct margin was submitted for each gallbladder. Statistical comparisons of GBC incidence and clinicopathologic features was performed. In group 1, GBC prevalence was 0.6 % and low grade dysplasia (LGD) was detected in 199 cases (1.8 %). In group 2, GBC prevalence was 1.5 %, LGD was detected in 166 cases (3.2 %). The GBC rate in Group 2 was significantly (p < 0.05) higher than Group 1. The two groups did not show any statistically significant differences in age, sex and presence of gallstones (p > 0.05). In conclusion, this is the largest study comparing two grossing methods in gallbladders without preoperative clinical and/or radiological suspicion of malignancy and macroscopically identified mass. This study demonstrates the importance of systematic and algorithmic sampling in the detection of GBC.

Impact of 18F FDG PET/CT on management of incidental gallbladder carcinoma

BackgroundIncidental gallbladder carcinoma (IGBC) is identified after cholecystectomy being performed for a presumed to be benign disease, and histopathology turns out as malignant disease. For optimal management planning, it is crucial to know the actual disease status. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) provides local, regional as well as distant disease, i.e., restaging and identifying true burden of disease for optimal treatment planning. The aim of this study was to restage the IGBC patients on 18F FDG PET/CT and find out any change in treatment plan.MethodsThis retrospective descriptive study was performed between November 2021 and February 2023. All PET/CT scans were analyzed which came for restaging in IGBC.ResultsPET/CT was performed at a median time of 9 weeks (range 6–12 weeks) from the date of surgery. This study included 17 patients (6 males and 11 females), with a median age of 55 years (range 38–76 years). From total of 17 PET/CT scans, 10 (58.8%) patients were positive and 7 (41.1%) patients were negative on PET/CT. Among the PET/CT positive patients, disease pattern was seen in the form of local/residual disease/liver infiltration, regional lymph nodes and distant metastases. Among the 17 patients, treatment plan in 5 patients (having PET/CT negative) was changed from surgical intervention to no treatment, and in 2 patients (having PET/CT positive), treatment plan was changed to chemotherapy, i.e., total 7 (5 + 2, 41% of total 17 patients) patients’ treatment plans were changed. By reducing the number of patients undergoing re-resection, we can say that it reduces the burden on already overburdened health infrastructure, especially in developing countries like India where incident is high.ConclusionsPET/CT provides the actual stage of IGBC. It changes treatment plan and reduces the number of patients undergoing re-resection. It also decreases burden on overburdened health infrastructure.

Incidental Gall Bladder Carcinoma - A Rare Case with Review of Literature

Incidental Gall Bladder Carcinoma - A Rare Case with Review of Literature

Unusual and extremely rare sites of metastases in gallbladder carcinoma

Gallbladder carcinoma is an aggressive neoplasm that is often diagnosed only in the later stages of the disease progression. Common sites of distant metastases of primary carcinoma gallbladder include lymph nodes, peritoneum and lung. Only a few cases of metastases to adrenal glands and kidneys have been reported in literature. Cutaneous and muscular metastases from gallbladder cancer are also unusual, and an extensive literature search revealed only a few cases to date. We present two such cases of gallbladder carcinoma which presented with metastases to these rare sites at the time of diagnosis which were detected by 18 fluorodeoxyglucose positron emission tomography/ computed tomography (18F FDG PET/CT). The first case is of a 45-year-old lady who presented to the general surgery department with complaints of abdominal pain, loss of appetite and nausea for 2 months. Conventional imaging with ultrasound and contrast-enhanced computed tomography (CECT) of the abdomen showed asymmetric gallbladder wall thickening occupying the fundus and body with extensive regional lymphadenopathy. 18F FDG PET/CT revealed a metabolically active gallbladder mass with bilateral adrenal gland lesions with cutaneous, muscular and skeletal metastases. The second case is of a 35-year-old lady who complained of left upper quadrant abdominal pain and nausea for one month. Successive CECT and Magnetic Resonance Cholangiopancreatography (MRCP) studies made the radiological diagnosis of gallbladder neoplasm. Pre-operative 18F FDG PET/CT showed a metabolically active gallbladder mass with bilateral adrenal gland lesions, lymph node involvement and bilateral renal metastasis. The Third case was 75 years old male who had incidental carcinoma gall bladder on cholecystectomy and PETCT was done for staging, and it showed metabolically active liver SOL, Bilateral adrenal deposits with mediastinal abdominal, retroperitoneal and lymph nodes. The fourth case is a 55 year old female who was diagnosed as neck gall bladder wall thickening on ultrasonography on further evaluation PETCT was done which showed hypermetabolic gall bladder neck wall thickening along with bilateral adrenal lesion and abdominal, retroperitoneal and retro-crural and right supraclavicular lymph nodes. Adrenal and other metastasis detection on 18F FDG PET/CT led to a change in the management from curative surgery to palliative chemotherapy in all patients. Thus,18F FDG PET/CT is a valuable modality in such type of cases that aids decision making regarding staging, appropriate management and monitoring response to therapy.

Role of Morphology and Immunohistochemistry in the Diagnosis of Incidental Cancers in Gallstone Disease

Introduction: The majority of gallbladder adenocarcinomas have been known to develop from dysplasia or carcinoma in situ, without pre-existing adenomas, hence observation of these non-neoplastic or preneoplastic lesions is important as it may underlie an occult malignancy. To study the role of morphology and immunohistochemistry in the diagnosis of incidental cancers in cases of gall stone disease by adopting a universal histopathological screening policy for all the gallstone disease cases operated at our tertiary care center. Material and Methods: The present study was designed as an observational cross sectional study completed over a time period of 14 months. A total of 176 cases were included in the study including all the patients of gall stone disease in the adult age group. All the indeterminate and frankly malignant cases were subjected to immunohistochemistry with a panel of antibody markers including p53, CEA and Ki-67 using Streptavidin Biotin immunoperoxidase method Fisher-exact test was used to compare the data taking‘p’ value less than 0.05 as statistically significant. Results: Mean age of patients was 40.55±13.25 years. Majority of patients (n=141; 80.1%) were females. The final diagnosis revealed a dominance of non-neoplastic inflammatory (n=168; 95.5%) pathology. There were 8 (4.5%) of malignancy, of these 7 were adenocarcinoma and 1 was adenosquamous carcinoma. Atypia was seen in 5 (2.8%) cases and 3 (1.7%) cases were of dysplasia. Histopathology detected carcinoma in 7 (4%) cases whereas addition of immunohistochemistry helped to find out one more unidentified case, thus the diagnostic yield increased to 8 (4.5%) cases. Out of three dysplasia cases, one (33.3%) was found positive on immunohistochemistry, which was later confirmed to be malignant. None of the cases of atypia were positive on p53, Ki-67 and CEA immunohistochemistry. On comparison between the three groups, the results were statistically significant (p=0.00062). Conclusion: Immunohistochemistry has a useful role in detection of incidental gallbladder carcinoma when morphology is limited by indeterminate results. A panel of immunohistochemical markers including p53, Ki-67 and CEA may prove very useful to pick up cases of malignancy in such cases of diagnostic dilemma.

Role of Detailed Intraoperative Macroscopic Examination of Cholecystectomy Specimens for Deciding Specimens Needing Histological Evaluation for Diagnosing Incidental Carcinoma of Gallbladder at the Earliest? A Systematic Review

Background: Several studies recommending selective or routine histopathological examination of gallbladder specimens have been done. However, the argument between these studies is based on intraoperative suspicion of IGBC (incidental gallbladder carcinoma) for deciding on specimen sending. This study aims to know whether a detailed intraoperative examination of cholecystectomy specimens is required for deciding on specimens needing histological evaluation and suspecting IGBCs at the earliest. Methodology: The systematic review has been done as per the PRISMA guidelines. Various articles were searched in Scopus, PubMed, Web of Science and Science Direct databases. This systematic review comprises studies involving patients diagnosed with benign gallbladder disease that underwent cholecystectomy but were later diagnosed with IGBC on routine or selective histological examination. Results: Out of the 26 studies that were chosen, 12 recommended routine histopathology and 14 recommended selective histopathology. The total number of gallbladders included in these studies was 79769, and the IGBCs diagnosed on histology were 494. The gross macroscopy of IGBCs diagnosed in routine histology recommending studies overlapped with the intraoperative macroscopic picture of the IGBCs diagnosed in selective histology recommending studies based on which the surgeons suspected them, thereby showing a need for detailed intraoperative macroscopic examination of gallbladders to avoid overlooking any IGBC. Conclusion: Detailed intraoperative examination of cholecystectomy specimens is essential for suspecting IGBCs at the earliest and for selective histopathology, as in its absence, a significant number of IGBCs are missed by surgeons. Keywords: cholecystectomy, pathology, gallbladder, carcinoma

UNEXPECTED GALL BLADDER CARCINOMA – A SURPRISING HISTOPATHOLOGICAL DIAGNOSIS

Objective: To determine the frequency of gall bladder carcinoma incidentally diagnosed in patients undergoing routine laparoscopic cholecystectomy. Material and Methods: Histopathology section of Pathology Department, Azra Naheed Medical College Raiwind Road, Lahore from January 2018 to July 2021. A total of 214 simple or laparoscopic cholecystectomy specimens were included. Detailed gross &amp; microscopic examination was done. All diagnoses including benign histopathological findings and incidental gall bladder carcinoma were analyzed. The important findings like resection margin involvement, maximum wall thickness of gallbladder, type of adenocarcinoma and TNM staging were noted. Results: Out of 214 simple or laparoscopic cholecystectomy specimens, there were three (1.4%) cases of incidental gallbladder carcinoma exclusively found in females. Mean age recorded was 45.7 years. Maximum thickness of gall bladder wall was 4.7 cm and maximum stage was pT2. Conclusion: According to our study there were three cases of incidental gallbladder carcinomas out of 214 cholecystectomy specimens. Considering this, histopathological study of gall bladder is essential not to miss any carcinoma, keeping in view the grim prognosis. Key Words: Gall bladder, Incidental carcinoma, Cholecystectomy, Cholelithiasis.

Does Timing of Completion Radical Cholecystectomy Determine the Survival Outcome in Incidental Carcinoma Gallbladder: A Single-Center Retrospective Analysis.

IntroductionIncidental discovery of gallbladder cancer (GBC) on postoperative histopathology or intra-operative suspicion is becoming increasingly frequent since laparoscopic cholecystectomy became the standard of care for gallstone disease. Incidental GBC (IGBC) portends a better survival than primarily detected GBC. Various factors affect the outcome of re-resection with the timing of re-intervention an important determinant of survival.MethodsAll patients of IGBC who underwent curative resection from January 2009 to December 2018 were considered for analysis. Details of demographic profile, index surgery, and operative findings on re-resection, histopathology and follow-up were retrieved from the prospectively maintained database. Patients were evaluated in three groups based on the interval between index cholecystectomy and re-resection: Early (<4 weeks), Intermediate (4-12 weeks) and Late (>12 weeks), using appropriate statistical tests.ResultsNinety-one patients were admitted with IGBC during the study period of which 48 underwent re-resection with curative intent. The median age of presentation was 55 years (31-77 years). The median duration of follow-up was 40.6 months (Range: 1.2-130.6 months). Overall and disease-free survival among the above-mentioned three groups was the best in the early group (104 and 102 months) as compared to the intermediate (84 and 83 months) and late groups (75 and 73 months), though the difference failed to achieve statistical significance (p=0.588 and 0.581). On univariate analysis, factors associated with poor outcome were node metastasis, need for common bile duct (CBD) excision and high-grade tumor. However, on multivariate analysis, poor differentiation was the only independent factor affecting survival.ConclusionEarly surgery, preferably within four weeks, possibly entails better survival in incidentally detected GBC. The grade of a tumor, however, is the most important determinant of survival in IGBC.

Incidental Gallbladder Neoplasms: A Growing Global Burden.

BackgroundThe increasing trend of laparoscopic procedures has made cholecystectomies one of the most common surgical specimens received for histopathological evaluation. This has also led to an increasing trend of finding incidental gallbladder malignancies for a presumed benign disease. The present study describes the histopathological spectrum of neoplastic lesions of the gallbladder along with the historadiological correlation with special emphasis on incidental gallbladder carcinomas (IGBC).Materials and methodsAll the cholecystectomies received over a span of two and a half years were studied. Demographic details, imaging findings, gross features, and microscopic findings of premalignant and malignant lesions were noted. Special stains were done as and when required.ResultsOf the 1253 cholecystectomies received during the study period, 50 gallbladders (3.9%) showed neoplastic pathology and were included in the present study. The age range was 40 to 60 years with female predominance. Ultrasonography revealed nonspecific wall thickness in both premalignant and incidental gallbladder carcinomas. Gallstones were seen in 74% of the cases (37/50). Gross and imaging findings in 17 (34%) of the malignant cases were in concordance with microscopic features, whereas the dysplastic lesions (21) and IGBC cases showed evidence of chronic cholecystitis on the same. Microscopic examination revealed focal dysplasia (low and high grade) in 21/50 (42%) cases. Invasive malignancy was seen in 28/50 (56%) of the cases, of which 11 cases (22%) were IGBC. Pancreaticobiliary type of adenocarcinoma was the most common morphology seen in almost all the cases. There was also one case each of intracholecystic papillary neoplasm (ICPN) and carcinosarcoma.ConclusionGBC is an unusual malignancy and its preoperative diagnosis is not so definitive. The incidental form of GBC presents as a radiological disguise and a histopathological surprise. Hence, the present study warrants a complete and scrupulous histopathological examination of all the cholecystectomy specimens for proper and further management of the case.

A STUDY OF OCCURENCE OF INCIDENTAL CARCINOMA OF GALL BLADDER IN OPERATED CASES OF GALL STONE DISEASE

Introduction: The issue of incidental gall bladder carcinoma was elaborated in 1771, by Maximilian Stoll at Vienna for the rst time.1 Cholecystectomy has a most peculiar and commonest indication which is cholelithiasis and the prevalence rate is high in North India and where it varies from 2 to 29 %. The region of North India has a higher risk for the incidence of gall bladder carcinoma. The survival rates of those patients who are undergoing a resection for incidental gall bladder carcinoma are more or less similar to the patients who are undergoing the primary radical surgery. Materials And Methods: Study will be conducted on 155 patients, undergoing lap/open cholecystectomy, attending the surgical OPD and emergency of TMMC&amp;RC, Moradabad. Informed consent will be taken from all the subjects. Findings of Routine &amp; relevant investigation (example - Ultrasonography of abdomen / CECT Abdomen / MRCP of abdomen) will be noted. Intraoperative ndings will be noted. Histopathology report ndings will be noted. Analyzed and discussed under following variables – 1. Demographic prole (age, sex) 2. Histopathology report Results: The age group 36 to 45 years is a mostly affected age group, the most common diagnosis is chronic cholecystitis and it is also noticed that females are mainly affected from gallbladder carcinoma. Conclusion: Prognosis of incidental gallbladder carcinoma can come up with better results when it is being diagnosed during the early stages.

Evaluation of gallbladder mucosal changes about the type of stones in patients undergoing open cholecystectomy: A study of 184 patients

Background: Cholelithiasis is 7 times more frequent in North India, with an overall incidence of about 2–29%. The number and different morphology of gallstones can cause alterations in the gallbladder (GB) mucosa. GB mucosal change depends on the duration of cholelithiasis, size, number, type of stone, and the gender of the patient. The coexistence of gallstones with cholecystitis, hyperplasia, intestinal metaplasia, and carcinoma is well known in the literature. Incidental gallbladder (GB) carcinoma is revealed in 1% of all cholecystectomies done for benign conditions. The pathological stage of the disease decides the prognosis of the disease. Aims and Objectives: Gallstones are known to produce various histopathological changes in the GB. We aim to correlate gallstone characteristics such as (number and morphological type) with the type of mucosal response in the GB (inflammation, hyperplasia, metaplasia, and carcinoma). Materials and Methods: A study of gallstones was done in 184 cases of open cholecystectomies based on the histological changes. One hundred and sixty-five (89.95%) were associated with gallstones, and the rest 19 cases (10.05%) were of acalculous cholecystitis. The changes in the mucosa of the calculous GB (165 cases) were studied, and the correlation between the mucosal changes and the number and type of stones was evaluated. Tissue sections for histopathological studies were taken from the fundus, body, neck, and abnormal-looking areas of the GB. Results: A gender study revealed a higher incidence of inflammatory changes in males, while GB hyperplasia, intestinal metaplasia, and cancer were found only in females. Conclusion: Correlation of mucosal changes with a number, duration of disease, and morphological type of stones has suggested that there could be an association with the various GB mucosal changes such as inflammation, hyperplasia, metaplasia, and carcinoma of the GB.

Oncologic Extended Resection of T3-Stage Incidental Gallbladder Carcinoma

Oncologic Extended Resection of T3-Stage Incidental Gallbladder Carcinoma

Incidental Gallbladder Carcinoma: An Eastern Indian Experience and Necessity of Routine Histopathological Examination after All Cholecystectomy

Introduction: The carcinoma of gallbladder is the most common malignancy of the biliary tract. The incidence of this carcinoma varies geographically. Incidental gallbladder carcinoma is diagnosed during histopathological examination after cholecystectomy due to other reasons. Histopathological examination of all cholecystectomy specimens are very essential to rule out these incidental gallbladder carcinomas. Aim: To this study to estimate the frequency of incidental gallbladder carcinoma in patients undergoing routine cholecystectomy and also to evaluate the necessity of routine histopathological examination after all cholecystectomy. Materials and Methods: A retrospective observational study was conducted in Department of Pathology, Midnapore Medical College and Hospital, West Bengal, India between January 2014 to December 2019 (six years) covering 650 patients who underwent laparoscopic and open cholecystectomy. Patients' demographic data, pathologic results, macroscopic appearance of the specimen, cancer staging were recorded and frequency of incidental gallbladder carcinoma were calculated. Result: Total 650 cholecystectomy specimens due to benign gallbladder disease were received in pathology department. Histopathological examination revealed 18 cases of incidental gallbladder carcinoma which comprised 2.8% of all the cholecystectomies. Among them 13 were female and five were in male with male: female ratio of 1:2.6 and the age ranges from 35 to 68 years. Among 18 cases 10 cases showed invasion upto lamina propria (stage T1a), five) cases had invasion in muscular layer (stage T1b) and three cases showed perimuscular connective tissue invasion (stage T2a). Conclution: The present study observed that the incidence of incidental gallbladder carcinoma in cholecystectomy specimen was little higher range in East Indian population and so routine histopathological examination of all cholecystectomy specimens are recommended.