Title: Gall bladder Carcinoma: A Review of Common Ultrasound Findings in a High Incidence Region

Authors: Dr Sithanthaseelan M, Dr Vinita Thakur, Dr Rezaul Karim

 DOI: https://dx.doi.org/10.18535/jmscr/v10i12.19

Abstract

Gall bladder carcinoma (GBC) is a debilitating and one of the commonest malignancies especially twice more common among women in the GBC belt of north india. Due to its late inconspicuous presentation and advanced stage at initial diagnosis it has one of the poorest prognoses among the malignancies and has a mean survival of 6 months. An early diagnosis is rare and ultrasound diagnosis is difficult and at times unreliable due to subjective discrepancies. Studies have identified striking geographic differences where inordinately high occurrence in north Indians living in the Gangetic belt yet low elsewhere especially in the south and western India. Incidence of GBC in women in northern India is as high as 9 per 1,00,000 per year as compared to 1 per 1,00,000 per year in southern India. Female sex, oily fried foods, long intervals between meals, congenital biliary tract anomalies and a genetic predisposition represent important risk factors. GBC are most commonly associated with cholelithiasis and chronic inflammation from biliary tract and parasitic infections Environmental triggers. Mortatlity rate is very high with 5 year survival rate at 5%. Recent advances in operative treatment shows promising results, making it even more essential to detect a GBC early on in the spectrum of the disease. : Due to late presentation the commonest finding was an infiltrating mass which carried a bad prognosis requiring some from screening mechanism for early detection of GBC.

Keywords: gall bladder carcinoma, geographic difference, cholelithiasis, incidence, ultrasound.

References

  1. Lazcano-Ponce EC, Miquel JF, Muñoz N, et al. Epidemiology and molecular pathology of gallbladder cancer. CA: Cancer J Clin 2001. 2001;51(6):349–364.  
  2. D. Levy, L.A. Murakata, C.A. Rohrmann Jr. Gallbladder carcinoma: radiologic–pathologic correlation. Radiographics, 21 (2001), pp. 295–314
  3. Abhishek Vijayakumar, Avinash Vijayakumar, Vijayraj Patil, M. N. Mallikarjuna, and B. S. Shivaswamy, “Early Diagnosis of Gallbladder Carcinoma: An Algorithm Approach,” ISRN Radiology, vol. 2013, Article ID 239424, 6 pages, 2013. doi:10.5402/2013/239424.
  4. E. Jung, J.M. Lee, K. Lee, et al. Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern
  5. Fong Y, Kemeny N, Lawrence TS. Cancer of the Liver andBiliary tree. In: DeVita VT Jr, Hellman S, Rosenberg SA,editors. Cancer : Principles and Practice of Oncology. 6thed.Philadelphia: Lippincott, Williams and Wilkins, 2002; 1187-202.
  6. U. Sons, F. Borchard, B.S. Joel Carcinoma of the gallbladder: autopsy findings in 287 cases and review of the literature J Surg Oncol, 28 (1985), pp. 199–206
  7. Grulich AE. Mcredie M. Coates M. Cancer incidence in Asian migrants to New South Wales Australia. Br J Cancer 1995;71:400-408.
  8. Grand, K.M. Horton, E.K. Fishman CT of the gallbladder: spectrum of disease AJR, 183 (2004), pp. 163–170
  9. Chun KA, Ha HK, Yu ES, Shinn KS. Xantho-granulomatous cholecystitis : CT features with emphasis on differentiation from gallbladder carcinoma. Radiology 1997; 203 : 93-7.
  10. Soo Jin Kim, Jeong Min Lee, Jae Young Lee, et al. Analysis of enhancement pattern of flat gallbladder wall thickening on MDCT to differentiate gallbladder cancer from cholecystitis
  11. Haaga JR, Herbener EH. The gallbladder and biliary tract. In: Haaga JR, Lanzieri CF, Gilkeson RC, editors. CT and MR Imaging of the whole body. 4th ed. St Louis: Mosby, 2003; 1357-60.
  12. J. Yun, S.G. Cho, S. Park, et al. Gallbladder carcinoma and chronic cholecystitis: differentiation with two-phase spiral CT Abdominal Imaging, 29 (2004), pp. 102–108
  13. Yoshimitsu K, Honda H, Shinoraki K, Aibe H. Helical CT of the local spread of carcinoma of the gallbladder: evaluation according to the TNM system in patients who underwent surgical resection. Amer J Roentgen 2002; 179: 423-8
  14. Kim BS, Ha HK, Lee IJ, Kim JH. Accuracy of CT in staging of Gallbladder carcinoma. Acta Radiol 2002; 43 : 25.
  15. Kumaran V, Gulati S, Paul B, Pande K. The role of dual phase helical CT in assessing resectability of carcinoma of the gallbladder. Europ Radiol 2002; 12: 1993-9.
  16. Kapoor VK, McMichael AJ. Gallbladder cancer: An ‘Indian’ disease. The Nat Med Jour India. 2003;16:209–213.
  17. National Cancer Registry Program Report. http://www.icmr.nic.in/ncrp/PBCR_Report%202009_2011. Accessed on 22 April 2015.

Corresponding Author

Dr Sithanthaseelan M.

DMRD. DNB. EDIR, Senior Resident, Department of Radiology, MGM, Medical College, Kishanganj, Bihar, India