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Case of the Month

June 2012

Patient Data: 65 year old female

Clinical Info: Abnormal liver function tests

There is an abnormal gallbladder filled with echogenic material sludge or tumor?

Another image of the abnormal gallbladder that also contains gallstones

Another image of the stones in the gallbladder

43241-9337636_20111011__0001.swf videoclip of the abnormal gallbladder

The mass is vascularized

43244-9337636_20111011__0003.swf videoclip

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

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

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

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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