Gallbladder carcinoma

Gallbladder carcinoma is a malignant epithelial neoplasm arising from the gallbladder. Most gallbladder carcinomas are adenocarcinomas.

General

• Uncommon.

Treatment:

• Cholecystectomy +/- lymph nodes +/- partial hepatectomy.

Epidemiology

• Associated with gallstones.
• Increased risk in primary sclerosing cholangitis.
• Sex: female > male.
• Location: usually fundus, sometimes body.

Notes:

• Diffuse calcification of gallbladder wall, AKA "porcelain gallbladder" is not associated with carcinoma - based on a series of 10,741 cholecystectomies.
  • Focal mucosal calcification is associated with malignancy.
• Cholangiocarcinoma is dealt with in the liver neoplasms article.

Gross

• Classic: mass projecting into the lumen.
• Marked gallbladder wall thickening.
  • >10 mm should be considered with suspicion.

Image:

• Papillary gallbladder adenocarcinoma (flickr.com).

Microscopic

Features:

• Usually adenocarcinoma.
  • Mimics appearance of pancreatic ductal adenocarcinoma -- but less cellular mucin.

Notes:

• May be very subtle, i.e. difficult to differentiate from normal glands.
  • "Deep glands" that look bland shouldn't immediately be dismissed as benign.

DDx:

• Adenomyoma of the gallbladder.
• Metastatic carcinoma.
  • Cholangiocarcinoma.

Images

• 

  GB carcinoma - low mag. (WC)

• 

  GB carcinoma - high mag. (WC)

• 

  GB carcinoma - LVI. (WC)

See also

• Gallbladder.
• Intestinal metaplasia of the gallbladder.