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Actual status of clinical diagnosis in patients with primary gallbladder cancer associated with adenomyomatosis

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Abstract

Aim

The purpose of this study was to reveal differences in clinical diagnosis of gallbladder cancer among patients with or without adenomyomatosis (ADM) by analyzing demonstrated tumor patterns on imaging and diagnostic opportunities.

Methods

Ninety-seven patients with gallbladder cancer were enrolled. Demonstrated imaging patterns were classified into mass lesion (ML), wall thickening (WT), and papillary lesion (PL). Clinical status during periodic follow up and other diagnostic opportunities were determined from medical records.

Results

All adenomyomatosis-associated cases were diagnosed at the T2 or higher stage. The distribution of demonstrated imaging patterns was significantly different between the adenomyomatosis-associated and non-adenomyomatosis-associated groups (p = 0.0002). No adenomyomatosis-associated gallbladder cancer had the PL pattern, which was readily identifiable and characteristic of early-stage cancer. The WT pattern presented difficulties for diagnosis, and the ML pattern was relatively specific, although most of these cases were at advanced stages. Approximately 40 % of ADM patients were found to be in advanced stages of gallbladder cancer, in spite of undergoing periodic follow up.

Conclusions

This study revealed the difficulty of early diagnosis of primary gallbladder cancer in the setting of concurrent ADM. Current results suggest the possible utility of preventive cholecystectomy for management of asymptomatic ADM patients.

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References

  1. Sobin L, Gospodarowicz M, Wittekind C, (eds). TNM Classification of Malignant Tumors. 7th ed. Hoboken: John Wiley & Sons, Inc.; 2009. p. 118–121.

  2. Furuse J, Kasuga A, Takasu A, Kitamura H, Nagashima F. Role of chemotherapy in treatments for biliary tract cancer. J Hepatobiliary Pancreat Sci. 2012;19:337–41.

    Article  PubMed  Google Scholar 

  3. Furuse J, Takada T, Miyazaki M, et al. Guidelines for chemotherapy of biliary tract and ampullary carcinomas. J Hepatobiliary Pancreat Surg. 2008;15:55–62.

    Article  PubMed  Google Scholar 

  4. Miyakawa S, Ishihara S, Takada T, et al. Flowcharts for the management of biliary tract and ampullary carcinomas. J Hepatobiliary Pancreat Surg. 2008;15:7–14.

    Article  PubMed  Google Scholar 

  5. Miyazaki M, Takada T, Miyakawa S, et al. Risk factors for biliary tract and ampullary carcinomas and prophylactic surgery for these factors. J Hepatobiliary Pancreat Surg. 2008;15:15–24.

    Article  PubMed  Google Scholar 

  6. Jutras JA, Longtin JM, Levesque HP. Hyperplastic cholecystoses. Am J Roentgenol Radium Ther Nucl Med. 1960;83:795–827.

    PubMed  CAS  Google Scholar 

  7. Jutras JA, Levesque HP. Adenomyoma and adenomyomatosis of the gallbladder. Radiol Clin North Am. 1966;4:483–500.

    Google Scholar 

  8. Ootani T, Shirai Y, Tsukada K, Muto T. Relationship between gallbladder carcinoma and the segmental type of adenomyomatosis of the gallbladder. Cancer. 1992;69:2647–52.

    Article  PubMed  CAS  Google Scholar 

  9. Nabatame N, Shirai Y, Nishimura A, Yokoyama N, Wakai T, Hatakeyama K. High risk of gallbladder carcinoma in elderly patients with segmental adenomyomatosis of the gallbladder. J Exp Clin Cancer Res. 2004;23:593–8.

    PubMed  CAS  Google Scholar 

  10. Kai K, Ide T, Masuda M, et al. Clinicopathologic features of advanced gallbladder cancer associated with adenomyomatosis. Virchows Arch. 2011;459:573–80.

    Article  PubMed  Google Scholar 

  11. Ash-Miles J, Roach H, Virjee J, Callaway M. More than just stones: a pictorial review of common and less common gallbladder pathologies. Curr Probl Diagn Radiol. 2008;37:189–202.

    Article  PubMed  Google Scholar 

  12. Aldridge MC, Gruffaz F, Castaing D, Bismuth H. Adenomyomatosis of the gallbladder. A premalignant lesion? Surgery. 1991;109:107–10.

    PubMed  CAS  Google Scholar 

  13. Funabiki T, Matsumoto S, Tsukada N, Kimura T, Yoshizaki S, Horibe Y. A patient with early gallbladder cancer derived from a Rokitansky–Aschoff sinus. Surg Today. 1993;23:350–5.

    Article  PubMed  CAS  Google Scholar 

  14. Kawarada Y, Sanda M, Mizumoto R, Yatani R. Early carcinoma of the gallbladder, noninvasive carcinoma originating in the Rokitansky–Aschoff sinus: a case report. Am J Gastroenterol. 1986;81:61–6.

    PubMed  CAS  Google Scholar 

  15. Terada T. Gallbladder adenocarcinoma arising in Rokitansky–Aschoff sinus. Pathol Int. 2008;58:806–9.

    Article  PubMed  Google Scholar 

  16. Albores-Saavedra J, Shukla D, Carrick K, Henson DE. In situ and invasive adenocarcinomas of the gallbladder extending into or arising from Rokitansky–Aschoff sinuses: a clinicopathologic study of 49 cases. Am J Surg Pathol. 2004;28:621–8.

    Article  PubMed  Google Scholar 

  17. Kai K, Ide T, Egashira R, et al. A unique case of gallbladder cancer arising in the neck side of segmental adenomyomatosis that mimicked hepatocellular carcinoma on contrast CT. Oncol Gastroenterol Hepatol Rep. 2012;1:33–6.

    Article  Google Scholar 

  18. Nishimura A, Shirai Y, Hatakeyama K. Segmental adenomyomatosis of the gallbladder predisposes to cholecystolithiasis. J Hepatobiliary Pancreat Surg. 2004;11:342–7.

    Article  PubMed  Google Scholar 

  19. Ching BH, Yeh BM, Westphalen AC, Joe BN, Qayyum A, Coakley FV. CT differentiation of adenomyomatosis and gallbladder cancer. AJR Am J Roentgenol. 2007;189:62–6.

    Article  PubMed  Google Scholar 

  20. Ram MD, Midha D. Adenomyomatosis of the gallbladder. Surgery. 1975;78:224–9.

    PubMed  CAS  Google Scholar 

  21. Stunell H, Buckley O, Geoghegan T, O’Brien J, Ward E, Torreggiani W. Imaging of adenomyomatosis of the gall bladder. J Med Imaging Radiat Oncol. 2008;52:109–17.

    Article  PubMed  CAS  Google Scholar 

  22. Irie H, Kamochi N, Nojiri J, Egashira Y, Sasaguri K, Kudo S. High b-value diffusion-weighted MRI in differentiation between benign and malignant polypoid gallbladder lesions. Acta Radiol. 2011;52:236–40.

    Article  PubMed  Google Scholar 

  23. Tongdee R, Maroongroge P, Suthikeree W. The value of MDCT scans in differentiation between benign and malignant gallbladder wall thickening. J Med Assoc Thai. 2011;94:592–600.

    PubMed  Google Scholar 

  24. Kim SJ, Lee JM, Lee JY, et al. Analysis of enhancement pattern of flat gallbladder wall thickening on MDCT to differentiate gallbladder cancer from cholecystitis. AJR Am J Roentgenol. 2008;191:765–71.

    Article  PubMed  Google Scholar 

  25. Tsukada K, Takada T, Miyazaki M, et al. Diagnosis of biliary tract and ampullary carcinomas. J Hepatobiliary Pancreat Surg. 2008;15:31–40.

    Article  PubMed  Google Scholar 

  26. Kondo S, Takada T, Miyazaki M, et al. Guidelines for the management of biliary tract and ampullary carcinomas: surgical treatment. J Hepatobiliary Pancreat Surg. 2008;15:41–54.

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Pathology and Microbiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga City, Saga, 849-8501, Japan

    Keita Kai, Masanori Masuda & Osamu Tokunaga

  2. Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga City, Saga, 849-8501, Japan

    Hiroyuki Irie

  3. Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga City, Saga, 849-8501, Japan

    Takao Ide, Kenji Kitahara, Atsushi Miyoshi, Kohji Miyazaki & Hirokazu Noshiro

Authors
  1. Keita Kai
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  2. Hiroyuki Irie
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  3. Takao Ide
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  4. Masanori Masuda
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  5. Kenji Kitahara
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  6. Atsushi Miyoshi
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  7. Kohji Miyazaki
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  8. Hirokazu Noshiro
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  9. Osamu Tokunaga
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Corresponding author

Correspondence to Keita Kai.

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Kai, K., Irie, H., Ide, T. et al. Actual status of clinical diagnosis in patients with primary gallbladder cancer associated with adenomyomatosis. Indian J Gastroenterol 32, 386–391 (2013). https://doi.org/10.1007/s12664-013-0355-9

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  • DOI: https://doi.org/10.1007/s12664-013-0355-9

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