Gall bladder carcinoma: Aggressive malignancy with protean loco-regional and distant spread

作     者：Amit Nandan Dhar Dwivedi Shivi Jain Ruhi Dixit 

作者机构：Department of Radiodiagnosis and Imaging Institute of Medical Sciences Banaras Hindu University Department of General Surgery Institute of Medical Sciences Banaras Hindu University 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2015年第3卷第3期

页      面：231-244页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Gallbladder cancer Loco-regional and distant spread Cholelithiasis Imaging Adenocarcinoma 

摘      要：The most common malignancy of biliary tract is gallbladder cancer(GBC) which is the third most common cancer in gastrointestinal tract. It is a lethal disease for most patients in spite of growing awareness and improved diagnostic techniques. GBC has a verypoor prognosis and the 5 year survival rate is 10%. Although etiology of the carcinoma of the gallbladder is still obscure, various factors have been implicated, cholelithiasis being the most frequent. The incidence of GBC worldwide is based on the gender, geography and ethnicity which suggest that both genetic and environmental factors can cause GBC. The major route of spread of gallbladder cancer(GC) is locoregional rather than distant. It spreads by lymphatic, vascular, neural, intraperitoneal, and intraductal routes. Sonography is usually the most common imaging test to evaluate symptoms of biliary tract disease including suspected GC. With recent advances in imaging modalities like multi-detector computed tomography(CT) scanners, magnetic resonance imaging-positron emission tomography/CT diagnosis of gallbladder cancer has improved. Studies have also targeted molecular and genetic pathways. Treatment options have included extended and radical surgeries and adjuvant chemotherapy. This review article deals in detail with important aspects of carcinoma gallbladder and its manifestations and challenges. Role of various imaging modalities in characterization and accurate staging has been discussed. The loco-regional spread of this aggressive malignancy is dealt explicitly.