A case of gallbladder cancer which was diagnosed in the follow-up term for post acute cholecystitis

Abstract

A 78-year old man with fever and abdominal pain was admitted to our hospital with acute cholecystitis. Conservative treatment did not improve his condition. We performed PTGBD, and he recovered immediately. Diagnostic imaging did not reveal the cause of the cystic duct obstruction and he declined a cholecystectomy. After six months, US and CT showed not only continued wall thickness, but also an elevated (timorous) lesion of the gallbladder. The tumor marker CA19-9 was continuously elevated and we diagnosed carcinoma of the gallbladder. However, he declined to undergo surgery. One year after the onset of acute cholecystitis, he finally underwent wedge resection of the gallbladder bed and regional lymphadenectomy. The pathologic findings showed; adenocarcinoma, tub1, pHinf2, pN1, stage IVa and he underwent chemotherapy with gemcitabine. However, liver and lymph node metastases were detected three months after the operation and he died from the disease ten months after surgery.