Introduction
Carcinoma of the gallbladder is an uncommon tumour that constitutes 1% of all cancers. >90% are adenocarcinomas; other types include anaplastic or squamous
Risk factors
- Gallstones
- Female
- Obesity
- Chronic cholecystitis
- Old age
- Chronic typhoid infection
- Porcelain gallbladder
Clinical features
Clinical features usually mimic cholecystitis. They may include:
- Right upper quadrant pain
- Weight loss
- Loss of appetite
- Biliary obstruction – jaundice
Investigations
Carcinoma of the gallbladder is often detected at the time of planned cholecystectomy for gallstones.
Diagnosis can be made using ultrasonography and the disease staged through CT scanning.
Management
If it has not spread, surgical excision can be offered and can be curative in early lesions.
However, most cases present with spread to lymph nodes or surrounding tissue. Only palliative treatment can be offered if the disease has spread.
Prognosis
Very poor prognosis. 5-year survival is 5% and most die within 1 year of symptoms onset.
Spread to lymph nodes and surrounding tissue is common. It most commonly spreads to the liver, bile duct, stomach and duodenum.
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