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Case of the Month

June 2012

Patient Data: 65 year old female

Clinical Info: Abnormal liver function tests


43239-Afbeelding2.jpg
There is an abnormal gallbladder filled with echogenic material sludge or tumor?


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Another image of the abnormal gallbladder that also contains gallstones


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Another image of the stones in the gallbladder


43241-9337636_20111011__0001.swf videoclip of the abnormal gallbladder


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The mass is vascularized


43244-9337636_20111011__0003.swf videoclip


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There is also a soft tissue mass along the edge of the liver


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Detail of the gallbladderwall. Part of the wall is intact and part is not


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There is also an abnormal common bile duct filled with stones


43249-Gallbladder_mass_CT.swf CT scan of the abnormal gallbladder and common bile duct filled with stones. The abnormal gallbladder was interpreted as very suspiscious for a gallbladder carcinoma


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The presence of the stones is confirmed with an ERCP. A papillotomy was performed and the liverfunction tests returned to normal


43250-gallbladder_carcinoma_2.swf Because the leverfunction tests were normal again the surgeon was reluctant to operate the gallbladder So a CT scan was repeated. There is now some air in the bile ducts


43252-gallbladder_carcinoma.swf CT


43253-gallbladder_carcinoma_3.swf CT scan clearly showing soft tissue stuctures in and outside the gallbladder. The patient was operated and the gallbladder and a part of the liver were removed

The mass proved to be a gallbladder carcinoma that had also extended outside the gallbladder in segment 5 of the liver which was also resected

For more examples of gallbladder carcinomas see

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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