Gallbladder adenocarcinoma

Case contributed by Domenico Nicoletti
Diagnosis certain

Presentation

Dyspepsia with right upper quadrant pain.

Patient Data

Age: 75 years
Gender: Male
ultrasound

There is a gallbladder stone and a coarse hyperechoic wall lesion, measuring 1.8 x 2.5 cm.

mri

There is a large polyp at gallbladder fundus that shows arterial phase enhancement that persists into later phases. There is also a large gallstone. The bile ducts aren't dilated. The liver is unremarkable.

Photo

Histologic analysis, post cholecystectomy.

Diagnosis(traduction):

Well-differentiated adenocarcinoma infiltrating the lamina propria in villous adenoma with high-grade epithelial dysplasia.

Chronic lithiasic erosive cholecystitis.

Presence of a metastasis-free lymph node.

Free excision margin.

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Case Discussion

Gallbladder cancer is a rare disease that often arises in the setting of chronic inflammation.

In the vast majority of patients, the source of this chronic inflammation is cholesterol gallstones.

Other more unusual causes of chronic inflammation are primary sclerosing cholangitis, ulcerative colitis, liver flukes, chronic Salmonella typhi and paratyphi infections.

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