Carcinoma of the gallbladder is a rare but aggressive cancer with a poor prognosis due to late detection. Risk factors include gallstones, chronic inflammation, and certain geographical or ethnic backgrounds. Early detection is key to improving outcomes, with surgery being the most effective treatment option. Preventative measures and regular monitoring for high-risk individuals can help reduce the incidence of this disease.
About
- Carcinoma of the gallbladder is a rare but highly aggressive form of cancer that originates in the gallbladder
Aetiology
- Gallstones: chronic inflammation caused by gallstones can lead to gallbladder cancer.
- Porcelain Gallbladder: A condition where the gallbladder wall becomes calcified, increasing cancer risk.
- Age and Gender: More common in older adults and has a higher incidence in females.
- Ethnicity and Geography: Higher rates South America, India, and Japan.
- Chronic Inflammation: Conditions like chronic cholecystitis can increase the risk of developing gallbladder cancer.
- Gallbladder Polyps: Polyps larger than 1 cm in the gallbladder are associated with a higher risk of malignancy.
Pathology
- 90% adenocarcinomas
- 10% squamous cell carcinomas
- Local spread to the liver
Clinical
- Abdominal pain, particularly in the upper right quadrant
- Nausea and vomiting
- Jaundice (yellowing of the skin and eyes)
- Unintended weight loss
- Loss of appetite
- Fever
- Pale or clay-colored stools
Investigations
- Imaging Studies: Ultrasound, CT scans, and MRI are commonly used to visualize the gallbladder and surrounding structures.
- Endoscopic Ultrasound (EUS): Provides detailed images and may be used to obtain biopsy samples.
- Biopsy: Tissue samples taken during imaging or surgery to confirm the diagnosis.
- Tumour Markers: Blood tests for markers like CA 19-9 and CEA may help in diagnosis and monitoring.
Management
- Surgery: The primary treatment, which may include cholecystectomy (removal of the gallbladder) and, in advanced cases, resection of surrounding tissues and lymph nodes.
- Chemotherapy: Often used after surgery to reduce the risk of recurrence or in cases where the cancer cannot be surgically removed.
- Radiation Therapy: May be used in combination with surgery or chaemotherapy, especially in advanced cases.
- Palliative Care: Focuses on relieving symptoms and improving quality of life for patients with advanced gallbladder cancer.