Misdiagnosis of carcinoma gall bladder in endemic regions

Abstract

Background Incidental carcinoma gall bladder and benign disease in radical cholecystectomy specimen is the cause of concern. We attempted to find out the incidence and reasons thereof in the present study. Methods Present study is a retrospective analysis of a prospectively maintained database between July 2002 and July 2019. All patients with a diagnosis of carcinoma gall bladder admitted for surgery were included. Results Out of 148 patients, 110 patients had carcinoma gall bladder (CAGB), while 38 patients (25.7%) had incidental carcinoma (under-diagnosis). Radical resection was done in 61/110 (55.4%) patients with clinical CAGB, where 15 (24.6%) patients had benign pathology (“over-diagnosis”). Overdiagnosis was due to xanthogranulomatous cholecystitis (n = 9), chronic cholecystitis (n = 2), tuberculosis (n = 2) and IgG4 related cholecystitis (n = 2). Among 61 patients, a history of weight loss and anorexia were significantly associated with malignancy. Asymmetrical wall thickness was significantly more common in benign mimickers. Among patients with incidental carcinoma, preoperative ultrasonography reported normal wall thickness of gall bladder in 28 (73.7%), thickened gall bladder wall in 6, and polyp in 3 patients. The resectability rate among incidental carcinoma was 27/38 (71.05%). Conclusion Over-diagnosis of the carcinoma gall bladder was present in 24.6%. On the other hand, incidental carcinoma comprised 25.7% of all admissions for carcinoma gall bladder with resectability of 71%.

Importance of accurate diagnosis of congenital agenesis of the gallbladder from atypical gallbladder stone presentations: A case report

“…CAGB is an extremely rare congenital anomaly characterized by absence of the gallbladder[ 8 , 9 ]. Due to its rarity and atypical presentation, CAGB often poses a diagnostic challenge and can be easily misdiagnosed as cholecystitis or other gallbladder disorders[ 3 , 10 , 11 ]. This case report highlights the significance of accurate diagnosis, appropriate preoperative imaging, and careful surgical evaluation in patients with suspected CAGB.…”

Comments and Illustrations of Ultrasound Findings in Extrapulmonary Tuberculosis Manifestations

“…Calcification may be indicative of tuberculosis, as well as the involvement of the neighboring liver or lymph nodes [70,71]. An irregular heterogeneously enhancing thickened gall bladder wall has been described as a manifestation of tuberculosis [72,73]. The most common differential diagnoses are gallbladder carcinoma or xanthogranulomatous cholecystitis [72].…”

“…An irregular heterogeneously enhancing thickened gall bladder wall has been described as a manifestation of tuberculosis [72,73]. The most common differential diagnoses are gallbladder carcinoma or xanthogranulomatous cholecystitis [72].…”