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Case Reports
. 2021 Mar 16;21(1):133.
doi: 10.1186/s12893-021-01117-2.

The giant resectable carcinoma of gall bladder-a case report

Lovenish Bains  1 , Haraesh Maranna  2 , Pawan Lal  2 , Ronal Kori  2 , Daljit Kaur  2   3 , Varuna Mallya  2   4 , Veerpal Singh  2
Affiliations
Case Reports

The giant resectable carcinoma of gall bladder-a case report

Lovenish Bains et al. BMC Surg. .

Abstract

Background: Gall bladder cancer (GBC) is the fifth most common malignancy in the gastrointestinal system and the most common malignancy of the biliary system. GBC is a very aggressive malignancy having a 5 year survival rate of 19%. Giant Gall Bladder (GGB) is an uncommon condition that can result from cholelithiasis or chronic cholecystitis and rarely with malignancy.

Case report: A 65 year old lady presented with vague abdominal pain for 12 years and right abdominal lump of size 20 × 8 cms was found on examination. CT scan showed a circumferentially irregularly thickened wall (2.5 cm) of gall bladder indicative of malignancy. Per-operatively a GB of size 24 × 9 cm was noted and patient underwent radical cholecystectomy. It was surprise to find such a giant malignant GB with preserved planes. Histopathology, it was well differentiated adenocarcinoma of gall bladder of Stage II (T2a N0 M0).

Discussion: It is known that mucocoele of GB can attain large size, however chronic cholecystitis will lead to a shrunken gall bladder rather than an enlarged one. A malignant GB of such size and resectable is rare without any lymph node involvement or liver infiltration. Few cases of giant benign gall bladder have been reported in literature, however this appears to be the largest resectable gall bladder carcinoma reported till date as per indexed literature.

Conclusion: Giant GB is an uncommon finding. They are mostly benign, however malignant cases can occur. Radiological findings may suggest features of malignancy and define extent of disease. Prognosis depends on stage of disease and resectability, irrespective of size.

Keywords: Carcinoma; Cholecystectomy; Gall bladder (GB); Gall bladder cancer (GBC); Giant.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
CT scan (coronal plane) showing large GB reaching towards pelvis
Fig. 2
Fig. 2
CT scan (transverse plane) showing thickened irregular GB wall
Fig. 3
Fig. 3
MRCP (T1 image) showing irregular thickened walls with large stones
Fig. 4
Fig. 4
MRCP (T2 image) showing bulk of tumor in neck and body
Fig. 5
Fig. 5
Intra-operative- GB till anterior superior iliac spine
Fig. 6
Fig. 6
Intra-operative—24 × 9 cm GB with neovascularization over body and neck, dissected structures (inset)
Fig. 7
Fig. 7
Opened specimen showing thickened irregular wall and large stones along with photomicrographs showing adenocarcinoma, H&E
See this image and copyright information in PMC

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