Porcelain Gallbladder: Decoding the malignant truth

Abstract

Gallbladder calcification, also referred to as porcelain gallbladder, has received significant attention in the medical literature due to its perceived role in increasing the risk of developing a gallbladder carcinoma. However, recent reports raise questions challenging this purported high risk. While previous studies reported a concomitant incidence of gallbladder cancer in porcelain gallbladder ranging from 7-60%, more recent analyses indicate the incidence to be much lower (6%). Based on evidence in the current literature, a prophylactic cholecystectomy is not routinely recommended for all patients with porcelain gallbladder and should be restricted to those with conventional indications, such as young patients. However, it is important to note that a nonoperative approach may require prolonged follow-up. A laparoscopic cholecystectomy is a feasible therapeutic option for patients with porcelain gallbladder, although some researchers have indicated a higher incidence of complications and conversion due to technical difficulties.

Keywords: Carcinomas; Cholecystectomy; Gallbladder Diseases; Physiological Calcification.

Figure 1

A: Plain X-ray revealing a diffuse intramural calcification (arrow) in a patient with a porcelain gallbladder. B: Computed tomography of the abdomen showing rim calcification of the gallbladder wall (arrow) in a patient with a porcelain gallbladder. Reproduced with permission from Sen KK, Upadhyaya A, Pimpalwar Y, D’souza J. Cancer in porcelain gallbladder: Rare imaging trait.