Sacrum metastasis in carcinoma gall bladder: an unusual presentation

Disseminated blood-borne metastases from carcinoma of the gall bladder are uncommon and usually occur late. The most common site of extra-abdominal metastasis is lung followed by brain. Skeletal metastases in carcinoma gall bladder are very rare. To date there have only been a few case reports of bone metastasis in carcinoma gall bladder at the time of presentation. Authors here present a rare case of carcinoma gall bladder that progressed to isolated sacrum metastasis.

Histopathological spectrum of gall bladder lesions

Background: Gall bladder diseases are a very common health problem that affects millions of people throughout the world. Cholelithiasis is commonly associated with carcinoma gallbladder. Cholecystectomy is the most commonly performed surgical procedure done for gall bladder disease.Methods: A total of 161 cases of gall bladder lesions were evaluated from January 2017 to December 2018 which were sent to department of pathology. Specimens were fixed in 10% formalin. Appropriate areas were selected from the specimen and grossed, processed, sectioned, stained using haematoxylin and eosin and were observed under microscope.Results: Out of 161 cases, 105 were female (65.22%) and 56 cases were male (34.78%).Histopathologically, the most common diagnosis was Chronic calculus cholecystitis (57.76%) followed by chronic acalculus cholecystitis (22.36%). Remaining cases were of Acute on chronic cholecystitis (6.21%), Acute on chronic cholecystitis with cholelithiasis (4.96%), Acute on chronic cholecystitis with perforation peritonitis (1.24%), Acute suppurative cholecystitis with perforation peritonitis (0.62%), Biliary Atresia (1.24%), Chronic cholecystitis with choledochal cyst (1.24%), Follicular cholecystitis (1.24%), Adenocarcinoma (0.62%), Adenosquamous carcinoma (0.62%) and one case was inconclusive (0.62%).Conclusions: The incidence of chronic calculus cholecystitis was found to be 57.76% with female preponderance and mostly in third decade. Malignancy of gall bladder is a rare condition. Routine histopathological examination of all cholecystectomy specimens is strongly recommended for the detection of various variants of chronic cholecystitis and also of incidental carcinoma of gall bladder which helps in their treatment and prognosis.

Incidence of Incidental Gall Bladder Carcinoma in Cases of Routine Cholecystectomy – A One Year Prospective Study in a Tertiary Care Hospital

Gall stones,gall bladder polyps,porcelain gall bladder leads to carcinoma.Malignancy is detected with a history of gall stone disease and patient presents with non-specific symptoms such as abdominal discomfort,right upper quadrant pain,nausea,vomitting,weight loss,anorexia and jaundice at a later stage .The aim of the study is to find the incidence of gall bladder carcinoma in cases of routine cholecystectomy. Methods: 100 cases were selected for this study. Open cholecystectomy / laparoscopy were done as routine cases and sent for histo-pathological study .The patients were clinically examined.clinica; symptoms, USG findings were corroborated. The follow up period was one year .The age of presentation,clinical examination,USG findings,was documented. Results: Gall bladder carcinoma is arare disease and 7 times more common in patients with gall stones. Conclusion: Predisposing conditions like gall bladder polyps more than 2 cms,porcelain gall bladder may tend to develop malignancy.Morbidity and mortality is associated with this disease due to early spread to liver,lymph node spread and jaundice.