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Type:
Educational Exhibit
Keywords:
Calcifications / Calculi, Metastases, Cancer, Staging, Imaging sequences, Comparative studies, Ultrasound, CT, MR, Oncology, Biliary Tract / Gallbladder, Abdomen
Authors:
K. Bansal, A. Arora, B. Sureka, C. Bihari, S. K. Sarin; New Delhi/IN
DOI:
10.1594/ecr2015/C-1785
Background
Gallbladder cancer is the most common malignancy of the biliary tract,
representing 80%-95% of biliary tract cancers worldwide.
In the UK around 800 cases are diagnosed each year and it affects women more frequently than men,
with about 7 out of every 10 cases diagnosed in women.
The older age groups are most often affected,
and in vast majority of cases coexisting gallstones are present.
In the United States,
it is the sixth most common gastrointestinal malignancy,
following cancer of the colon,
pancreas,
stomach,
liver,
and esophagus and it is estimated that fewer than 5000 new cases are diagnosed each year.
The symptoms at presentation are non-specific and are most often related to adjacent organ invasion,
contributing to advanced staging and poor prognosis at the time of diagnosis.
Therefore,
despite advances in cross-sectional imaging,
it is difficult to detect early-stage tumors.
Imaging studies may reveal a mass replacing the normal gallbladder,
diffuse or focal thickening of the gallbladder wall,
or a polypoid mass within the gallbladder lumen (Figure 1).
Adjacent organ invasion,
most commonly involving the liver and biliary dilatation,
is typically present at diagnosis.
Periportal and peripancreatic lymphadenopathy,
hematogenous metastases,
and peritoneal metastases may also be seen.
The well to moderately differentiated adenocarcinoma accounts for the vast majority of gallbladder carcinomas.
Because most patients present with advanced disease,
the prognosis is dismal,
with a median survival of 6 months and reported 5-year survival rate of less than 5% in most large series.
The radiologic differential diagnosis includes the more frequently encountered inflammatory conditions of the gallbladder,
xanthogranulomatous cholecystitis,
adenomyomatosis,
other hepatobiliary malignancies,
and metastatic disease.
This exhibit reviews and illustrates the pathologic and radiologic spectrum of gallbladder carcinoma and its differential diagnosis