Gallbladder Carcinoma Presenting Research Articles

Comparison of Chemotherapy Combined with Percutaneous Electroporation and Chemotherapy Alone in the Management of Locally Advanced Gallbladder Carcinoma (GBC): A Study Protocol.

This study aims to evaluate the feasibility and efficacy of chemotherapy combined with irreversible electroporation (IRE) in patients with locally advanced gallbladder carcinoma (GBC) presenting as gallbladder masses. Patients with unresectable GBC masses of size greater than 2cm and less than 6cm without evidence of distant metastases and with no contraindication to general anaesthesia will be enrolled in the study. They will be randomized using computer generated table into two arms with 1:1 allocation ratio to include 15 patients in each group. Group I will be the chemotherapy alone arm and Group II will be the combined image-guided irreversible electroporation of the tumour and chemotherapy arm. The primary outcome assessed shall be the clinical benefit rate (complete response, CR; partial response, PR and stable disease, SD) based on the mRECIST criteria and overall survival. The secondary outcome shall be feasibility and safety of the procedure and quality of life pre and post procedure. The quality of life will be assessed by a questionnaire as given by EORTC-Quality of Life Group before starting therapy and 4weeks after completion of therapy. The combined local and systemic effects of irreversible electroporation and systemic chemotherapy respectively may improve the outcomes in inoperable cases of gallbladder carcinoma. Clinical Trials Registry - India ( https://ctri.nic.in/Clinicaltrials/advancesearchmain.php ). Identifier: CTRI/2021/05/033803. Primary Register of the International Clinical Trials Registry Platform (WHO ICTRP) ( http://www.who.int/ictrp/search/en/ ).

An Unusual Presentation of Primary Gallbladder Carcinoma

An Unusual Presentation of Primary Gallbladder Carcinoma

Gallbladder cancer in Eastern Province of Saudi Arabia: A retrospective cohort study.

BackgroundThere is paucity in the literature regarding gallbladder cancer in Saudi Arabia, possibly because it is not among the top 10 cancers diagnosed nationwide according to the Saudi Cancer Registry. Moreover, national or regional data on gallbladder cancer in Saudi Arabia have not been analyzed. The purpose of this study was to describe the presentation, disease stage, histology, and survival rates for gallbladder cancer in Saudi patients at a single institution between January 1, 2010 and December 31, 2017.Materials and methodsThis was a retrospective study of 76 patients who presented to our hospital between January 1, 2010 and December 31, 2017, with established diagnosis of gallbladder carcinoma. The diagnosis was made either histopathologically following simple laparoscopic cholecystectomy or biopsy from metastatic liver lesion in patients with gallbladder mass, or the high suspicion of gallbladder carcinoma based on incidental radiological findings. Presentation, disease stage, histology, and treatment modalities were analyzed using descriptive statistics and frequency distributions. Survival rates were analyzed and presented using Kaplan-Meier curves.ResultsBased on initial analyses the disease was more frequent among women (62.0%) than men (39.0%). Surgical resection was attempted in 40.8% patients. The average age at presentation and diagnosis of gallbladder carcinoma was 62.4 years. The disease had two peaks, one at 51.0 years and the other between 66.0 and 70.0 years. The median survival time for the overall at-risk patients was only 1.0 year, while for stage IVB patients was 7.2 months. Adenocarcinoma not otherwise specified (NOS) was the most common histopathology type (75.0%), with most patients presenting with stage IVB disease (75.0%). Gallbladder carcinoma was incidentally detected in 42.1%, including three cases (3.9%) diagnosed at our hospital.ConclusionsGallbladder cancer is a rare type of cancer in Saudi Arabia, and most patients are treated surgically, despite being mostly diagnosed at the advanced stage of the disease.

A Case of Flat Infiltrating-type Gallbladder Carcinoma Presenting as Hemorrhagic Cholecystitis

A Case of Flat Infiltrating-type Gallbladder Carcinoma Presenting as Hemorrhagic Cholecystitis

Presentation of gallbladder carcinoma and its surgical management

Objective:- To study the mode of presentation, age and sex distribution, socio-economic status and evaluation of various surgical methods adopted for treatment of localized and advanced gallbladder carcinoma. Design:- It was a prospective type of study. Place and duration of study: This study was conducted in the Department of Surgery Nishtar Hospital, Multan from January 2004 to June 2005. Patients and methods: Twenty five patients of all ages and both sex were taken from all surgical units. On the basis of history, examination and laboratory investigations they were suspected of having gallbladder cancer. All the patients were operated and were divided into three groups on the basis of operative findings and stage of disease. Results:- There were 4 males and 21 female with a male to female ratio of 1:5. Presenting feature in decreasing order of frequency were; pain in right hypochondrium in 88%, nausea and vomiting in 60%, weight loss in 40%, jaundice in 28%, anorexia in 28%, mass in right hypochondriu m in 24%, pruritis in 20%, fever in 12% and ascites in 4% patients. Preoperative diagnosis of carcinoma of gallbladder was possible in 12 (48%) patients with the help of ultrasound and CT scan but all were of advanced age of disease. Gall stone were the most important etiological factor in 20 (80%) patients, obesity was found in 7 (28%) and chronic typhoid infection in 2 (8%) patients. All patients were operated. Simple cholecystecytomy was done in 4 patients of stage I and II. Extended cholecystectomy done in 6 patients of stage III. Laparotomy and biopsy of the mass and/or palliative surgery for drainage of bile was done in 15 cases of stage IV and V disease. Adenocarcinoma was the most common histological type found in 22 (88%) cases. Conclusion:- Gallstone are the most important etiological factor in gall bladder carcinoma.

Gallbladder Carcinoma Presenting with Perforation in an Eldery Patient

Gallbladder Carcinoma Presenting with Perforation in an Eldery Patient

Gall bladder carcinoma presenting with spinal metastasis: A rare phenomenon

Skeletal metastasis as a primary presentation of gall bladder carcinoma is rare. A 50-year-old lady presented with neck pain and weakness in her right upper limb of 3 months duration. Clinical and imaging work-up suggested locally advanced gall bladder carcinoma with metastasis to cervical vertebra and sternum. Only one case till date has been reported where the patient presented with neurological symptoms due to pathological fracture secondary to metastasis from an occult gall bladder carcinoma. Although rare, an occult gall bladder cancer may present with neurological symptoms due to pathological fracture of spine secondary to metastasis. We present a brief review of literature of patients who presented with skeletal metastases in clinically silent gall bladder malignancy. Palliative care issues in advanced gall bladder carcinoma have also been discussed.

Primary gallbladder carcinoma presenting as advanced-stage ovarian cancer

Primary gallbladder carcinomas are rare and the prognosisis very poor. The incidence is 1e2% of all gastro-intestinal(GI) tract cancers [1]. Information on ovarian metastasis ofprimary gallbladder cancer is limited [2e13], partly becauseprimary gallbladder cancers are rare, and partly becausemetastases from primary gallbladder cancer are mediatedthrough either lymphatic or hematogenous routes. Sinceprimary gallbladder cancers are mucinous tumors, there areproblems with the differential diagnosis if mucinous ovariancarcinomas are found. Furthermore, primary or secondaryovarian mucinous tumors may present similar clinical symp-toms, for example, non-specific GI symptoms or signs, andsimilar findings on imaging studies or tumor marker surveys.Before and during an operation, an accurate diagnosis some-times cannot be made [14]. Herein, we present a case ofsecondary ovarian mucinous cancer emanating from primarygallbladder mucinous carcinoma.An 84-year-old woman was sent to the emergency roombecause of diffuse abdominal pain and poor appetite. Clinicalexamination showed an acutely ill-looking woman withapparent peritoneal signs (diffuse tenderness and reboundingpain) associated with a lower abdominal mass. Ultrasoundshowed a 15-cm complex cystic mass in the right adnexa, butthe uterus and the left ovary were normal. Computed tomog-raphy further identified this 15-cm ill-defined right adnexalheterogeneous mass with diffuse peritoneal seeding andcarcinomatosis. Serum tumor markers, including CA 125, CA153, CA 199, and CEA were 327.3 U/mL, 29.0 U/mL, 218.0U/mL, and 85.8 ng/mL, respectively. The other hematologicaland biochemical tests were normal. Upper and lower gastro-intestinal tract evaluations were negative.Under the diagnosis of ovarian cancer, an exploratorylaparotomy was done. A complex cystic right ovarian masswith a mucinous component was found, as well as diffusecarcinomatosis involving the entire lower and upper abdom-inal cavity, including the omentum, in which the inflamedgallbladder was embedded. Frozen section of the removedovarian tumor favored the diagnosis of primary ovariancarcinoma, mucinous type. The patient underwent a subop-timal debulking surgery, including total hysterectomy, bilateralsalpingo-oophorectomy, omentectomy, and retroperitoneallymph node sampling, and multiple biopsies. The finalpathology was primary gallbladder mucinous carcinoma.Microscopic features showed hyperchromatic dysplasia ofthe mucinous glandular cells of the gallbladder; the mucinoustumor occupied the entire cavity of the gallbladder. The tumorhad invaded whole layers of the gallbladder, and penetrated tothe outside serosa and the attachment of the omentum. Othersections of the right ovary, appendix, omentum, abdominalwall, mesentery, and right pelvic lymph nodes all showedtumor metastases with floating mucinous tumor cells within anextensive mucin pool.Using the American Joint Committee on Cancer (AJCC)staging for gallbladder cancer, the final diagnosis was gall-bladder cancer stage IVB (pT4NxM1). However the patientdied of disease 48 days after the operation.This case report raised the following interesting issues.First, since 15% of ovarian cancers are secondary and 7e15%

胆囊十二指腸瘻を併存した胆石イレウスを契機に診断された早期胆囊癌の1切除例

症例は71歳の女性で，嘔吐を主訴に来院した．血液検査でCRPおよび肝･胆道系酵素の上昇が見られた．腹部CT像上，回腸内に3 cmの結石と口側小腸の拡張および胆管内気腫が見られた．イレウス管挿入時に十二指腸から胆囊が造影され，胆囊十二指腸瘻を伴う胆石イレウスと診断した．開腹所見で胆囊十二指腸瘻と回腸への結石嵌頓が見られた．嵌頓結石の摘出と胆囊摘出を試みたが，炎症性に胆囊管の同定が困難であったため胆囊を頸部で離断し瘻孔を含め摘出した．遺残胆囊頸部断端は結節縫合閉鎖した．摘出胆囊粘膜内には一部に異型腺管が散在し，抗p53抗体およびMIB-1陽性細胞が見られたため胆囊上皮内癌と診断された．非癌部粘膜には偽幽門腺化生が見られた．瘻孔への癌浸潤は認めなかったが切除断端が陽性であったため，初回手術から2か月後に根治切除を行った．内胆汁瘻を有する症例は胆囊癌の合併を念頭に置いて治療を行うべきと考えられた．

Sister Mary Joseph’s nodule as the first presentation of gallbladder carcinoma: <i>A case report and literature review

Metastatic umbilical deposits from abdominal and pelvic malignancy is termed Sister Mary Joseph’s nodule. Metastasis of gallbladder adenocarcinoma to the umbilicus is extremely rare, even rarer is for this metastasis to be the initial presentation of gallbladder carcinoma. We report a case of gallbladder carcinoma presenting as sister Mary Joseph’s nodule. Physicians should consider this type of metastasis in patients presenting with umbilical nodules and biopsy should always be obtained.

Occult gallbladder carcinoma presenting as a primary ovarian tumor in two women: two case reports and a review of the literature

IntroductionThe ovary is a common site of metastasis from various organs. However, little is known about gallbladder carcinoma metastasizing to the ovaries and presenting as a primary ovarian tumor.Case presentationWe report two cases of a metastatic gallbladder carcinoma which mimicked a primary ovarian tumor in a 35-year-old and a 62-year-old North Indian woman. Clinically, both our patients presented with abdominal masses without obvious signs and symptoms related to gallbladder carcinoma. Radiology suggested the possibility of a primary ovarian tumor with chronic cholecystitis and cholelithiasis. The gross features also mimicked a primary malignant ovarian tumor in the first case and a benign mucinous neoplasm in the second case. Exact diagnoses could only be made after thorough sampling from both the ovaries and gallbladder.ConclusionsGallbladder carcinoma with metastasis to the ovaries can mimic both malignant and benign primary ovarian tumors. Extensive cystic change in the ovary due to metastasis from gallbladder carcinoma has rarely been reported. A high index of suspicion and thorough sampling are essential to avoid misdiagnosis in such cases.

Sister mary joseph′s nodule as the first presentation of gallbladder carcinoma: A case report and literature review

Sister mary joseph′s nodule as the first presentation of gallbladder carcinoma: A case report and literature review

Gall bladder carcinoma presenting as multiple cavitary pulmonary metastases — a rare event

Carcinoma of the gall bladder is the commonest malignancy of the biliary tract. It is either detected incidentally during routine imaging or presents as lump in right hypochondrium or with signs of jaundice. Rarely, it may present with multiple cavitary metastatic lesions in the pulmonary parenchyma. The authors, report such a rare case of gall bladder carcinoma that presented with extensive, bilateral pulmonary cavitary metastases with no evidence of any nodal disease and where the diagnosis was delayed due to this rare presentation.

Gallbladder Carcinoma Presenting as Exfoliative Dermatitis (Erythroderma)

Although exfoliative dermatitis (erythroderma) secondary to malignancy is commonly associated with lymphomas or leukemias, coincident gastrointestinal (GI) malignancy and erythroderma is rare. The authors recently encountered a patient with gallbladder carcinoma presenting as erythroderma. A 77-yr-old Japanese man presented with a 3-mo history of erythematous eruptions with pruritus over almost the entire body. After confirming the diagnosis of erythroderma, asymptomatic gallbladder carcinoma was found. Further investigations detected no malignancies in other organs. An extended cholecystectomy was performed. Histologic examination of resected specimens revealed poorly differentiated adenocarcinoma with negative resection margins. The eruptions with pruritus resolved within 1 wk after the operation. This is the first report, to our knowledge, of coincident biliary malignancy and erythroderma. The experience of the current patient suggests that erythroderma secondary to GI malignancy may resolve spontaneously after curative resection of the tumor.

Gallbladder carcinoma presenting as duodenal obstruction

Gallbladder carcinoma presenting as duodenal obstruction

Gall bladder cancer presenting as upper gastrointestinal bleed: a rare initial presentation of gall bladder carcinoma

Gall bladder cancer presenting as upper gastrointestinal bleed: a rare initial presentation of gall bladder carcinoma

Carcinoma of the gallbladder presenting as scalp tumour

Carcinoma of the gallbladder is characterized by rapid tumour growth associated with lymphatic and local tumour invasion. The peritoneum, GIT and lungs are common sites of seeding. Distant metastasis to bone rarely occurs. Here we document a case of silent gallbladder carcinoma presenting as scalp tumour with improved survival.

Carcinoma of the gallbladder: color Doppler ultrasound and CT findings.

A case of a large polypoidal gallbladder carcinoma presenting with empyema is described. Heterogeneous echoes filled the gallbladder lumen on gray-scale sonography. Color Doppler ultrasound detected vascularity within the gallbladder lumen, thereby differentiating the intraluminal tumor from isoechoic sludge and pus. Correlative computed tomography showed an enhancing intraluminal mass, with small enhancing vessels that corresponded to those seen with color Doppler sonography.

Gallbladder Carcinoma Presenting as Acute Cholecystitis

Gallbladder Carcinoma Presenting as Acute Cholecystitis

Gallbladder and pancreatic metastasesfrom bilateral renal carcinoma presenting with hematobilia and anemia

A case of bilateral metachronous renal cell carcinoma withgallbladder and pancreatic metastases, presenting with hematobilia and anemia is presented. The presentation of metastatic renal cell carcinoma with hematobilia and anemia is previously unreported. This case illustrates (l) the occasionally very long interval between metachronous renal carcinoma; (2) this tumor's propensity to unusual metastases and unpredictable presentation; and (3) the significant palliation which may be achieved by appropriate surgical resection of these metastases.