Abstract
Carcinoma of gall bladder is the most common malignancy of the biliary tract worldwide and is usually associated with poor prognosis. In this era of laparoscopic cholecystectomy, there has been increase in detection of early stage incidental gall bladder carcinoma in cholecystectomy specimens. A retrospective study was carried out in tertiary care hospital in central India. A total of 2990 patients underwent laparoscopic cholecystectomy during the year 2001–2013. Hospital records and histopathology reports of these patients were studied in detail. Twenty three cases of gall bladder carcinoma were detected incidentally accounting for an incidence of 0.76 %. It was more common in females with an M: F ratio of 1:1.9. Mean age of presentation was 57.8 years. Gall stones were present in 22 cases and one patient presented with features of acute cholecystitis. Three patients had associated xanthogranulomatous inflammation and 10 had associated intestinal metaplasia. It is not uncommon to encounter incidental malignancies of gall bladder in laparoscopic cholecystectomy specimens sent to histopathology for presumably benign disease. Histopathology reports must include comments on extent of infiltration, perineural invasion, tumor differentiation and nodal involvement for oncologist information and subsequent management of patients.
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References
Cavallaro A, Piccolo G, Panebianco V, Menzo EL, Berrettta M, Zanghi A, Vita MD, Cappellani A (2012) Incidental gallbladder cancer during laparoscopic cholecystectomy: managing an unexpected finding. World J Gastroenterol 18(30):4019–4027
Sachidananda S, Krishnan AK, Venkataraman J (2012) Characteristics of gallbladder cancer in South India. Indian J Surg Oncol 3(3):228–230
Kalita D, Pant L, Singh S, Jain G, Kudesia M, Gupta K, Kaur C (2013) Impact of routine histopathological examination of gall bladder specimens on early detection of malignancy – study of 4,115 cholecystectomy specimens. Asian Pan J Cancer Prev 14(5):3315–8
Daphna W, Mehrdad H, Noa BJ, Sandbanand AH (2002) Incidental finding of gall bladder carcinoma. Israel Med Assoc J 4:334–6
Khoo JJ, Nurul AM (2008) A clinicopathological study of nine cases of gallbladder carcinoma in 1122 cholecystectomies in Johor Malaysia. Malays J Pathol 30(1):21–6
Mittal R, Jesudason MR, Nayak S (2010) Selective histopathology in cholecystectomy for gallstone disease. Indian J Gastroenterol 29:26–30
Zhang WJ, Xu GF, Petal ZX (2009) Incidental gallbladder carcinoma diagnosed during or after laparoscopic cholecystectomy. World J Surg 33:2651–6
Amanullah MK, Rizwn AK, Shahid S, Veena M (2007) Occult carcinoma of gallbladder: Incidence and role of simple cholecystectomy. JK-Practitioner 14:22–3
Ghimire P, Yogi N, Shrestha BB (2011) Incidence of incidental carcinoma gall bladder in cases of routine cholecystectomy. Kathmandu Univ Med J (KUMJ) 9(34):3–6
Siddiqui F G, Memon A A, Abro A H, Sasoli N A, Ahmad L (2013) Routine Histopathology of gallbladder after elective cholecystectomy for gallstones. BMC Surg 13:26
Ferrarese AG, Solej M, Enrico S, Falcone A, Catalano S, Pozzi G, Marola S, Martino V (2013) Diagnosis of incidental gallbladder cancer after laparoscopic cholecystectomy: our experience. BMC Surg 13(2):S20
Sujata JSR, Sabina K, Mi H, Jairaipuri ZS (2013) Incidental gall bladder carcinoma in laparoscopuc cholecystectomy: a report of 6 cases and review of the literature. J Clin Diagn Res 7:85–8
Kwon AH, Imamura A, Kitade H, Kamiyama Y (2008) Unsuspected gallbladder cancer diagnosed during or after laparoscopic cholecystectomy. J Surg Oncol 97:241–5
Ghnnam WM, Elbeshry TMAS, Malek JR, Emarra ES, Alzahrany ME, Alqarni AA, Khattab AA (2014) Incidental gallbladder carcinoma in laparoscopic cholecystectomy: Five years local experience. El Med J 2(1):47–51
Romano F, Franciosi C, Caprotti R et al (2001) Laparocsopic cholecystectomy and unsuspected gall bladder carcinoma. Eur J Surg Oncol 27:225–8
Shukla PJ, Barreto G, Neve R, Mohandas KM (2007) Shrikhande SV Can we do better than ‘incidental’ gallbladder cancer? Hepatogastroenterology 54(80):2184–5
Hale MD, Roberts KJ, Hodson J, Scott N, Sheridan M, Toogood GJ (2014) Xanthogranulomatous cholecystitis: a European and global perspective. HPB (Oxford) 16(5):448–58
Maesawa C, Ogasawara S, Yashima-Abo A, Kimura T, Kotani K, Masuda S, Nagata Y, Iwaya T, Suzuki K, Oyake T, Akiyama Y, Kawamura H, Masuda T (2006) Aberrant maspin expression in gallbladder epithelium is associated with intestinal metaplasia in patients with cholelithiasis. J Clin Pathol 59(3):328–30
Roa I, Ibacache G, Munoz S, de Aretxabala X (2014) Gallbladder cancer in Chile: pathologic characteristics of survival and prognostic factors: analysis of 1,366 cases. Am J Clin Pathol 141(5):675–82
Chatelain D, Fuks D, Farges O, Attencourt C, Pruvot FR, Regimbeau JM (2013) Pathology report assessment of incidental gallbladder carcinoma diagnosed from cholecystectomy specimens: results of a French multicentre survey. Dig Liver Dis 45(12):1056–60
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Gulwani, H.V., Gupta, S. & Kaur, S. Incidental Detection of Carcinoma Gall Bladder in Laparoscopic Cholecystectomy Specimens: A Thirteen Year Study of 23 Cases and Literature Review. Indian J Surg Oncol 6, 30–35 (2015). https://doi.org/10.1007/s13193-015-0379-y
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DOI: https://doi.org/10.1007/s13193-015-0379-y