Case | Clinical Presentation | Radiology | Gross Description | Final Diagnosis | |
---|---|---|---|---|---|
A | 66 yo male | abdominal pain, 4 years post cholecystectomy for ruptured cholecystitis and cholelithiasis | CT: peritoneal carcinomatosis and free fluid | Peritoneal implants with slight granular thickening of peritoneum Gallbladder wall 5 mm thick no mass, and gallstones in the lumen | Well differentiated adenocarcinoma of the gallbladder and peritoneal metastasis |
B | 49 yo female | On routine examination, pelvic mass and gallbladder polyp were found with no remarkable clinical symptoms | CT: an enhancing 2 cm mass in the GB fundus. US: heterogeneous mass with associated internal flow worrisome for GB malignancy: cholelithiasis | Polypoid mass protruding from a stalk (4.0 × 2.3 × 1.4 cm) gallstones. On cut section the polyp was white tan, homogeneous throughout | Combined adenocarcinoma and neuroendocrine carcinoma, poorly differentiated |
C | 86 yo female | Three days of RUQ pain, nausea, fever. History of breast cancer S/P mastectomy 7 years ago, treated with Tamoxifen, squamous cell carcinoma of nose, ovarian cyst removal | US & CT: gallstones and sludge; pancreatic head mass | BG 9.5 × 6.5 × 6.0 cm. seven firm yellow to black multi-faceted calculi. GB wall thickened to 1.5 cm. Mucosa lined by friable pale tan necrotic tissue extruded into lumen. 3.5 cm maximal tumor size, circumferential at neck and filling up to 30% of the luminal volume | Pancreatic biopsy: adenocarcinoma with abundant lymphocytes. GB: Undifferentiated carcinoma of GB with extensive necrosis and acute/chronic inflammation |
D | 53 yo female | Increasing abdominal girth over several months | CT & US: moderate volume ascites, 18.5 cm complex right pelvic mass; GB: 1.8 cm polyp | A 5 cm appendix filled with yellow-tan mucoid material. Gallbladder was 7.3 × 3 cm in greatest dimensions with a flesh colored lesion presenting in the serosa. The mucosa was unremarkable | Low grade mucinous neoplasm/adenocarcinoma of the appendix with peritoneal spread |
E | 45 yo female | RUQ pain | Cholelithiasis | Mural thickness 5 mm; no mass; stones up to 2.5 cm | Focally invasive adenocarcinoma; extensive CIS involving RAS |