Carcinoma involving gall bladder: a four year study in a tertiary care hospital in kashmir valley.

Abstract

BACKGROUND Carcinoma of gall bladder clinically mimics benign gall bladder diseases and often escapes detection until advanced stage. Careful attention to any evidence of wall thickening, thorough sampling and close examination of any deeply situated glandular structures are critical. AIMS To study the clinicopathological pattern of gall bladder malignancies. MATERIALS AND METHODS This was a 4 year retrospective study and carried in Department of Pathology, Government Medical College, Srinagar, Kashmir, between January 2015 and December 2018.Our study included 57 cases of gall bladder malignancies including incidental detected cases. RESULTS During this four year study, a total of 57 patients were studied. Male to female ratio of 0.78:1 was seen. The age of the patients ranged from 27-85 years and peak age incidence was seen in sixth decade of life. The most common presenting symptoms were pain abdomen followed by anorexia and dyspepsia. Grossly evident tumor was seen on initial pathologic examination in 49 cases (85%) while 8 cases grossly presented no visible tumor (i.e. incidental gall bladder carcinomas having only mild wall thickening undetected by imaging).The most common tumor sites were in the body and the fundus of gallbladder. The most common histologic type was adenocarcinoma NOS in 47 cases followed by papillary adenocarcinoma in 2 cases, mucinous adenocarcinoma in 2 cases, primary squamous cell carcinoma in 3 cases, and a single case each of neuroendocrine tumor and adenosquamous carcinoma. Immunohistochemistry was done, wherever needed, for confirmation. CONCLUSION GBC is not an uncommon clinical entity in Kashmir valley, unlike western countries. In spite of the advanced imaging techniques, early gall bladder carcinoma is not efficiently detected. Therefore, every gallbladder should be subjected to routine histopathological examination because with identification of an early gallbladder carcinoma a