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Case of the Month

January 2015

Patient Data: 59 year old female

Clinical Info: Patient suspected of having gallstones

Gallbladder with a stone and sludge or a polypoid lesion?

Transverse image of the sluge or polypoid lesion. What would be your next step?

With color doppler the lesion is vascularized, so it is solid and not sludge

Another image with flow in the mass. The common bile duct is normal

Transverse image of the polypoid lesion. The lesion has a broad base Lesions larger than 1cm. are suspiciuos of being or developing to a galllbladdercarcinoma. A CT scan was performed

55674-Mijn_Film_1.swf CT scan

55675-Mijn_Film_2.swf CT scan

55676-Mijn_Film_3.swf CT scan. No metastases were seen, so the patient was operated and unfortunately it proved to be a gallbladder carcinoma

The same patient 6 months later has liver metastases

Another image of the liver metastases of the same patient

liver metastases

This is the gallbladder in a much older patient

There is a mass in the gallbladder and the contour of the gallbladder is unsharp

Another image of the same patient. There is soft tissue around the gallbladder

There is a mass next to the gallbladder. The contour of the gallbladder and liver is very unsharp

56270-gallbladder_carcinoma.swf CT

56271-gallbladder_carcinoma_2.swf CT

56272-gallbladder_carcinoma_3.swf CT

A biopsy was performed

Both patients had a gallbladder carcinoma. The first patient had a carcinoma that looked limited but that involved all the gallbladder wall layers. The gallbladder and part of the liver had to be removed. One of the lymph nodes that were removed was also positive. Half a year later she has multiple liver metastases
In the second patient the gallbladder was to extensive to undergo an operation. Although many patients with gallbladder carcinoma have stones this patient had no identifiable stones.
The prognosis of patients with gallbladder carcinoma is very poor

For more cases of gallbladder carcinoma see

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