GALL BLADDER CARCINOMA
More common in Females
Mostly in the 7th decade of life
Risk factors
Gall stones – most important risk factor (↑size and duration, ↑ risk)
Porcelain Gall Bladder
Choledochal cyst
Chronic typhoid carriers
Cholecystoses
Cholesterosis of gall bladder (strawberry GB)
Clinical features
Nonspecific – indistinguishable from benign gall bladder disease like biliary colic or cholecystitis
Jaundice(less common), significant weight loss in short duration
CA 19-9 is elevated in 80%; CEA is also elevated in few cases
Diagnosis confirmed by multidetector row CT scan
Types
Adenocarcinoma is the me type (90%)
The tumor is most commonly nodular and infiltrative, with thickening of the gall bladder.
Nevin’s staging
I.Intramural
II. Spread to muscularis
III. Spread to serosa
IV. Spread to cystic lymph node of Lund (the sentinel node)
V. Direct spread to adjacent organs/Distant metastases
Treatment
Stage I and II - simple cholecystectomy
Stage III – cholecystectomy + adjacent hepatic resection (atleast 2cm depth) + regional lymphadenectomy
Poor prognosis