gallbladder cancer

Etiology

(associated factors)

• genetic predisposition
• gallstones
• gallbladder polyps
• calcification of the gallbladder wall (porcelain gallbladder)
• bile composition
• environmental carcinogens
• infections (Salmonella typhi)
• drugs

Epidemiology

• greatest incidence in patients > 65 years of age
• female/male ratio is 3/1
• most common biliary tract cancer, but still uncommon
  • < 5000 cases yearly
• highest incidence rates & mortality occur in Chile

Pathology

• commonly diagnosed at a late stage when prognosis is poor

Clinical manifestations

• may resemble biliary colic or cholecystitis
• abdominal pain is the most common initial complaint
  • pattern of pain is variable
• may be asymptomatic
• nausea/vomiting
• anorexia
• weight loss
• jaundice may occur
• a palpable mass may be felt
• ascites may occur

Laboratory

• serum chemistries
  • alkaline phosphatase may be elevated
  • bilirubin may be elevated
• tumor markers
  • CEA may be elevated, but is not diagnostic
  • CA 19-9 may be elevated, but is not diagnostic

Radiology

• abdominal ultrasound
  • thickening of gallbladder wall
  • gallbladder mass
  • calcification of gallbladder (porcelain gallbladder)
• computed tomography
• MRI cholangiopancreatography
  • ability to detect liver involvement
  • presence of regional lymph node & distant metastases
  • assessment of potential resectability

Management

• surgical resection (cholecystectomy)
  • only intervention that can result in a cure
  • 80% of patients have unresectable disease at the time of cholecystectomy
• chemotherapy does not improve survival
• radiation does not significantly improve survival

More general terms

• biliary carcinoma

Additional terms

• cholecystitis
• cholelithiasis (gallstones)

Patient information

gallbladder cancer patient information