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Gallbladder cancer is a relatively uncommon cancer. It has peculiar geographical distribution being common in central and south America, central and eastern Europe, Japan and northern India; it is also common in certain ethnic groups e.g. Native American Indians and Hispanics.^[1] If it is diagnosed early enough, it can be cured by removing the gallbladder, part of liver and lymph nodes. Most often it is found after symptoms such as abdominal pain, jaundice and vomiting occur, and it has spread to other organs such as the liver.

It is a rare cancer that is still being studied and thought to be related to gallstones building up, which also can lead to calcification of the gallbladder, a condition known as Porcelain gallbladder. Porcelain gallbladder is also rare. Some studies indicate that people with porcelain gallbladder have a high risk of developing gallbladder cancer, but other studies question this. The outlook is poor for recovery if the cancer is found after symptoms have started to occur.

Risk factors

• Gender: Approx. twice more common in women than men, mostly between the ages of 50 and 60.
• Obesity increases the risk for gallbladder cancer. It is common in north India and indigenous peoples of the Americas.
• Primary carcinoma is linked to chronic cholecystitis and cholelithiasis.

Signs and Symptoms

• Steady pain in the upper right abdomen
• Weakness
• Loss of appetite
• Weight loss
• Jaundice and vomiting due to obstruction

Early symptoms mimic gallbladder inflammation due to gallstones. Later, the symptoms may be that of biliary and stomach obstruction.

Disease Course

Most tumors are adenocarcinomas, with a small percent being squamous cell carcinomas. The cancer commonly spreads to the liver, bile duct, stomach,and duodenum.

Diagnosis

Incidentally discovered gallbladder cancer (adenocarcinoma) following a cholecystectomy. H&E stain.

Early diagnosis is not generally possible. People at high risk, such as women or Native Americans with gallstones, are evaluated closely. Transabdominal ultrasound, CT scan, endoscopic ultrasound, MRI, and MR cholangio-pancreatography (MRCP) can be used to diagnose.

Treatment

The most common and most effective treatment is surgical removal of the gallbladder (cholecystectomy) with part of liver and lymph node dissection. However, with gallbladder cancer's extremely poor prognosis, most patients will die by one year following the surgery. If surgery is not possible, endoscopic stenting of the biliary tree can reduce jaundice and a stent in stomach may relieve vomiting. Chemotherapy and radiation may also be used with surgery. If gall bladder cancer is diagnosed after cholecystectomy for stone disease (incidental cancer), reoperation to remove part of liver and lymph nodes is required in most cases - this should be done as early as possible as these patients have the best chance of long term survival and even cure.^[2]

Additional images

References

External links

• The Johns Hopkins Esophageal Cancer Web page