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Incidental metastases and lymphoma of the gallbladder–an analysis of ten rare cases identified from a large national database

Muszynska, Carolina LU ; Lundgren, Linda ; Andersson, Roland LU ; Søland, Torunn ; Lindell, Gert LU ; Sandström, Per and Andersson, Bodil LU orcid (2019) In Scandinavian Journal of Gastroenterology 54. p.350-358
Abstract

Background: The aim was to identify and characterize rare malignancies of the gallbladder, incidentally found at cholecystectomy, and describe the diagnostic work-up, treatment and outcome. Methods: Data from cholecystectomies during 2007–2014 registered in the Swedish Register for Gallstone Surgery (GallRiks) were analyzed for incidental cancer. For completion of the pathology report, data were linked with the Swedish Registry for Cancer in the liver and biliary tract (SweLiv) and/or the Swedish Cancer Registry. Results: From 36,355 patients that underwent cholecystectomy on a benign indication 215 cases of incidental gallbladder cancer (IGBC) were identified. In total seven patients with metastases to the gallbladder from different... (More)

Background: The aim was to identify and characterize rare malignancies of the gallbladder, incidentally found at cholecystectomy, and describe the diagnostic work-up, treatment and outcome. Methods: Data from cholecystectomies during 2007–2014 registered in the Swedish Register for Gallstone Surgery (GallRiks) were analyzed for incidental cancer. For completion of the pathology report, data were linked with the Swedish Registry for Cancer in the liver and biliary tract (SweLiv) and/or the Swedish Cancer Registry. Results: From 36,355 patients that underwent cholecystectomy on a benign indication 215 cases of incidental gallbladder cancer (IGBC) were identified. In total seven patients with metastases to the gallbladder from different primary tumors (breast cancer, malignant melanoma, gastric cancer, renal cell carcinoma, upper gastrointestinal cancer, colon cancer and pancreatic cancer) and three patients with lymphoma involvement of the gallbladder were found. Most patients were female with no difference between the groups (8/10 versus 171/215). The median age for the metastasis and lymphoma (MOL) group was equal to the IGBC group, 70 (64–72) years versus 70 (63–78) years. All patients in the MOL group underwent preoperative imaging with ultrasound or computed tomography, on which no metastases were identified. In only two patients a tumor was seen by the surgeon during the perioperative examination of the gallbladder. The median survival was 5.8 months for MOL patients and 23 months for IGBC patients. Conclusion: Metastases and lymphoma of the gallbladder are rare. Traditional imaging methods prior to cholecystectomy may miss gallbladder malignancies. A liberal approach of histopathological analysis of the gallbladder should be applied.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
adenocarcinoma, cholecystectomy, Gallbladder cancer, lymphoma, metastases
in
Scandinavian Journal of Gastroenterology
volume
54
pages
350 - 358
publisher
Taylor & Francis
external identifiers
  • scopus:85065169114
  • pmid:31035806
ISSN
0036-5521
DOI
10.1080/00365521.2019.1588363
language
English
LU publication?
yes
id
9e166d3e-b354-4324-a9a4-da661be1956c
date added to LUP
2019-05-24 12:49:55
date last changed
2024-04-30 10:08:38
@article{9e166d3e-b354-4324-a9a4-da661be1956c,
  abstract     = {{<p>Background: The aim was to identify and characterize rare malignancies of the gallbladder, incidentally found at cholecystectomy, and describe the diagnostic work-up, treatment and outcome. Methods: Data from cholecystectomies during 2007–2014 registered in the Swedish Register for Gallstone Surgery (GallRiks) were analyzed for incidental cancer. For completion of the pathology report, data were linked with the Swedish Registry for Cancer in the liver and biliary tract (SweLiv) and/or the Swedish Cancer Registry. Results: From 36,355 patients that underwent cholecystectomy on a benign indication 215 cases of incidental gallbladder cancer (IGBC) were identified. In total seven patients with metastases to the gallbladder from different primary tumors (breast cancer, malignant melanoma, gastric cancer, renal cell carcinoma, upper gastrointestinal cancer, colon cancer and pancreatic cancer) and three patients with lymphoma involvement of the gallbladder were found. Most patients were female with no difference between the groups (8/10 versus 171/215). The median age for the metastasis and lymphoma (MOL) group was equal to the IGBC group, 70 (64–72) years versus 70 (63–78) years. All patients in the MOL group underwent preoperative imaging with ultrasound or computed tomography, on which no metastases were identified. In only two patients a tumor was seen by the surgeon during the perioperative examination of the gallbladder. The median survival was 5.8 months for MOL patients and 23 months for IGBC patients. Conclusion: Metastases and lymphoma of the gallbladder are rare. Traditional imaging methods prior to cholecystectomy may miss gallbladder malignancies. A liberal approach of histopathological analysis of the gallbladder should be applied.</p>}},
  author       = {{Muszynska, Carolina and Lundgren, Linda and Andersson, Roland and Søland, Torunn and Lindell, Gert and Sandström, Per and Andersson, Bodil}},
  issn         = {{0036-5521}},
  keywords     = {{adenocarcinoma; cholecystectomy; Gallbladder cancer; lymphoma; metastases}},
  language     = {{eng}},
  pages        = {{350--358}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Gastroenterology}},
  title        = {{Incidental metastases and lymphoma of the gallbladder–an analysis of ten rare cases identified from a large national database}},
  url          = {{http://dx.doi.org/10.1080/00365521.2019.1588363}},
  doi          = {{10.1080/00365521.2019.1588363}},
  volume       = {{54}},
  year         = {{2019}},
}