• Title, Summary, Keyword: Gallbladder neoplasm

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Localized Adenomyomatosis of Gallbladder Mimicking Advanced Hepatic Flexure Colon Cancer: A Case Report (간만곡부 대장암으로 오인된 국소형 담낭 선근종증: 증례 보고)

  • Suh, Pae Sun;Kim, Bohyun;Lee, Dakeun;Lee, Ki Myung;Lee, Jei Hee;Kim, Hye Jin;Kim, Jai Keun
    • Journal of the Korean Society of Radiology
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    • v.79 no.5
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    • pp.290-293
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    • 2018
  • Localized forms of gallbladder adenomyomatosis are rarely polypoid and may mimic gallbladder cancer. Herein, we present a unique case of polypoid gallbladder adenomyomatosis penetrating the colon and preoperatively misdiagnosed as advanced hepatic flexure colon cancer.

Patterns of initial failure after resection for gallbladder cancer: implications for adjuvant radiotherapy

  • Kim, Tae Gyu
    • Radiation Oncology Journal
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    • v.35 no.4
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    • pp.359-367
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    • 2017
  • Purpose: This study sought to identify potential candidates for adjuvant radiotherapy and patterns of regional failure in patients who underwent curative-intent surgery for gallbladder cancer. Materials and Methods: Records for 70 patients with gallbladder cancer who underwent curative resection at a single institution between 2000 and 2016 were analysed retrospectively. No patients received adjuvant radiotherapy. Initial patterns of failure were evaluated. Regional recurrence was categorized according to the definitions of lymph node stations suggested by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. Results: Median follow-up was 23 months. Locoregional recurrence as any component of first failure occurred in 29 patients (41.4%), with isolated locoregional recurrence in 13 (18.6%). Regional recurrence occurred in 23 patients, and 77 regional recurrences were identified. Commonly involved regional stations were #13, #12a2, #12p2, #12b2, #16a2, #16b1, #9, and #8. Independent prognostic factors for locoregional recurrence were ${\geq}pT2$ disease (hazard ratio [HR], 5.510; 95% confidence interval [CI], 1.260-24.094; p = 0.023) and R1 resection (HR, 6.981; 95% CI, 2.378-20.491; p < 0.001). Conclusion: Patients with pT2 disease or R1 resection after curative surgery for gallbladder cancer may benefit from adjuvant radiotherapy. Our findings on regional recurrence may help physicians construct a target volume for adjuvant radiotherapy.

Is it Necessary to Submit Grossly Normal Looking Gall Bladder Specimens for Histopathological Examination?

  • Tayeb, Muhammad;Rauf, Fozia;Ahmad, Khurshid;Khan, Faiz Muhammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1535-1538
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    • 2015
  • Background: The objectives of the study were to: 1) determine the frequency of incidental malignancy in unsuspected/grossly normal looking gall bladders; 2) determine the frequency of malignancy in suspected/grossly abnormal looking gall bladders. Materials and Methods: This prospective, cross sectional study was carried out at a tertiary care hospital in Pakistan, during a four year period (Jan 2009-dec2012). All the cholecystectomy cases performed for gallstone diseases were examined initially by a surgeon and later on by a pathologist for macroscopic abnormalities and accordingly assigned to one of the three categories i.e. grossly normal, suspicious, abnormal/malignant. Frequency of incidental carcinoma in these categories was observed after receiving the final histopathology report. Results: A total of 426 patients underwent cholecystectomy for cholelithiasis, with a 1:4 male: female ratio. Mean age of the patients was 45 years with a range of 17-80 years. The frequency of incidental gallbladder carcinoma was found to be 0.70 %(n=3). All the cases of gallbladder carcinoma were associated with some macroscopic abnormality. Not a single case of incidental carcinoma gallbladder was diagnosed in 383 'macroscopically normal looking' gallbladders. Conclusions: Incidental finding of gall bladder cancer was not observed in any of macroscopically normal looking gall bladders and all the cases reported as carcinoma gallbladder had some gross abnormality that made them suspicious. We suggest histopathologic examination of only those gall bladders with some gross abnormality.

Cyclin D1, Retinoblastoma and p16 Protein Expression in Carcinoma of the Gallbladder

  • Srivastava, Vineeta;Patel, Brijesh;Kumar, Mohan;Shukla, Mridula;Pandey, Manoj
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2711-2715
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    • 2013
  • Background: Cancer of the gallbladder is a relatively rare neoplasm with a poor prognosis. The exact mechanisms of its genesis are not known and very little information is available on molecular events leading to labeling this as an orphan cancer. Materials and Methods: In this prospective case control study we evaluated the expression of p16, pRb and cyclin D1 by immunohistochemistry to study the G1-S cell-cycle check point and its possible role in gallbladder carcinogenesis. A total of 25 patients with gallbladder carcinoma (group I), 25 with cholelithiasis (group II) and 10 normal controls. were enrolled Results: Cyclin D1 expression was seen in 10 (40%) patients each with carcinoma and cholelithiasis while only in 2 (20%) of the normal gallbladders but differences were not statistically significant (p value=0.488). p16 was expressed in 12% patients of carcinoma of the gallbladder and 28% of cholelithiasis, however this difference was not statistically significant (p value=0.095). Retinoblastoma protein was found to be expressed in 50% of normal gallbladders and 6 (24%) of carcinoma and 8 (32%) of gallstones. The present study failed to demonstrate any conclusive role of cyclin D1/RB/ p16 pathway in carcinoma of the gallbladder. Conclusions: The positive relation observed between tumor metastasis and cyclinD1 expression and p16 with nodal metastasis suggested that higher cyclin D1/p16 expression may act as a predictive biomarker for aggressive behavior of gallbladder malignancies.

Intracystic Papillary Neoplasm of the Gallbladder Arising from a Localized Adenomyomatous Hyperplasia (국소형 선근종증에서 발생한 담낭내유두모양종양 1례)

  • Nam, Hyeong Seok;Kang, Dae Hwan;Choi, Byung Hyun;Kim, So Young;Lee, Jung Hee
    • The Korean Journal of Pancreas and Biliary Tract
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    • v.23 no.4
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    • pp.182-189
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    • 2018
  • Adenomyomatous hyperplasia (AMH) of the gallbladder commonly accompanies chronic cholecystitis and may be classified into three types according to the gross features: segmental, localized (fundal), and diffuse types. In situ or invasive carcinomas arising from and confined to AMH are rarely observed, especially of the segmental type. Intracystic papillary neoplasm (IPN) is one of the precancerous lesions of the gallbladder. IPN usually grows into the lumen and produces a polypoid or papillary mass. Here, we report an extremely rare case of IPN arising from and limited to a localized AMH incidentally detected in a brain-dead 68-year-old female patient during organ harvesting.

Photoacoustic Imaging for Differential Diagnosis of Benign Polyps versus Malignant Polyps of the Gallbladder: A Preliminary Study

  • Chae, Hee-Dong;Lee, Jae Young;Jang, Jin-Young;Chang, Jin Ho;Kang, Jeeun;Kang, Mee Joo;Han, Joon Koo
    • Korean Journal of Radiology
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    • v.18 no.5
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    • pp.821-827
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    • 2017
  • Objective: To investigate the feasibility of ex vivo multispectral photoacoustic (PA) imaging in differentiating cholesterol versus neoplastic polyps, and benign versus malignant polyps, of the gallbladder. Materials and Methods: A total of 38 surgically confirmed gallbladder polyps (24 cholesterol polyps, 4 adenomas, and 10 adenocarcinomas) from 38 patients were prospectively included in this study. The surgical specimens were set on a gel pad immersed in a saline-filled container. The PA intensities of polyps were then measured, using two separate wavelength intervals (421-647 nm and 692-917 nm). Mann-Whitney U test was performed for the comparison of normalized PA intensities between the cholesterol and neoplastic polyps, and between the benign and malignant polyps. Kruskal-Wallis test was conducted for the comparison of normalized PA intensities among the cholesterol polyps, adenomas, and adenocarcinomas. Results: A significant difference was observed in the normalized PA intensities between the cholesterol and neoplastic polyps at 459 nm (median, 1.00 vs. 0.73; p = 0.032). Comparing the benign and malignant polyps, there were significant differences in the normalized PA intensities at 765 nm (median, 0.67 vs. 0.78; p = 0.013), 787 nm (median, 0.65 vs. 0.77; p = 0.034), and 853 nm (median, 0.59 vs. 0.85; p = 0.028). The comparison of the normalized PA intensities among cholesterol polyps, adenomas, and adenocarcinomas demonstrated marginally significant differences at 765 nm (median, 0.67 vs. 0.66 vs. 0.78, respectively; p = 0.049). Conclusion: These preliminary results indicate that benign versus malignant gallbladder polyps might exhibit different spectral patterns on multispectral PA imaging.

Potential Therapeutic Targets for the Primary Gallbladder Carcinoma: Estrogen Receptors

  • Zhang, Ling-Qiang;Zhang, Xiu-De;Xu, Jia;Wan, Yong;Qu, Kai;Zhang, Jing-Yao;Wang, Zhi-Xin;Wei, Ji-Chao;Meng, Fan-Di;Tai, Ming-Hui;Zhou, Lei;Liu, Chang
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2185-2190
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    • 2013
  • Gallbladder carcinoma, the most frequent malignant neoplasm of the biliary tract system, has always been considered to feature late clinical presentation and diagnosis, limited treatment options and an extremely poor prognosis. In recent years, while the incidence of gallbladder cancer has appeared to be on the increase, the available treatment methods have not greatly improved survival of the affected patients. Thus, exploring new therapeutic targets for this devastating disease is an urgent matter at present. Epidemical studies have demonstrated that the incidence of gallbladder carcinoma exhibits a distinct gender bias, affecting females two to three times more than males, pointing to crucial roles of estrogen. It is well known that estrogen acts on target tissues by binding to estrogen receptors (ERs), which are mainly divided into three subtypes, $ER{\alpha}$, $ER{\beta}$ and $ER{\gamma}$. $ER{\alpha}$ and $ER{\beta}$ appear to have overlapping but also unique even opposite biological effects. As important pathogenic mediators, ERs have been considered to relate to several kinds of tumors. In gallbladder carcinoma tissue, ERs have been shown to be positively expressed, and ERs expression levels are associated with differentiation and prognosis of this cancer. Nevertheless, the exact mechanisms of estrogen inducing growth of gallbladder carcinoma remain poorly understood. On the base of the current investigations, we deduce that estrogen participates in promotion of gallbladder carcinoma by influencing the formation of gallstones, stimulating angiogenesis, and promoting abnormal proliferation. Since ERs mediate the carcinogenic actions of estrogen in gallbladder, and therapy targeting ERs may provide new directions for gallbladder carcinoma. Therefore, it should be stressed that ERs are potential therapeutic targets for gallbladder carcinoma.

Prevalences of Incidental Findings in Trauma Patients by Abdominal and Pelvic Computed Tomography

  • Lee, Jin Young;Jung, Myung Jae;Lee, Jae Gil;Lee, Seung Hwan
    • Journal of Trauma and Injury
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    • v.29 no.3
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    • pp.61-67
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    • 2016
  • Purpose: Abdominal and pelvic computed tomography (APCT) is frequently used as a diagnostic tool in trauma patients. However, trauma unrelated, incidental findings are frequently encountered. The aim of this study was to determine the prevalences of incidental findings on APCT scans in trauma patients. Methods: The archived records of 801 trauma patients treated from January 2013 to December 2015 were reviewed retrospectively. Six hundred and forty of these patients underwent contrast enhanced APCT in an emergency department and were included in this study, and 205 (32.1%) of these patients had incidental findings. These findings were divided into two categories: category I, meaning a radiological benign finding not requiring further evaluation or follow-up, and category II, requiring further evaluation and follow-up. Results: One hundred and sixty (24.8%) patients were allocated to category I and 45 (7.2%) to category II. The most frequent incidental findings were discovered in kidneys (34.6%), followed by liver (28.8%), and gallbladder (15.6%). The most frequent finding in category I was a benign cyst (60.1%), followed by a simple stone (15.6%), and hemangioma (11.9%). Adenomyomatosis of the gallbladder (17.8%) was the most common lesion in category II, followed by atypical mass (15.6%), complicated stone (15.6%) and cystic neoplasm (15.6%). Conclusion: The prevalence of an incidental finding on APCT scans was 32.1%. Although category II lesions were not common in trauma patients, these findings should be communicated to patients, and when necessary referred to a primary care physician. Systems are required for producing appropriate discharge summaries and informing patients about the implications of incidental findings.