© Borgis - New Medicine 2/2014, s. 55-56
*Konrad Wroński1, 2
Porcelain gallbladder – case report
1Department of Oncology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
Head of Department: prof. Sergiusz Nawrocki, MD, PhD
2Department of Surgical Oncology, Hospital Ministry of Internal Affairs with Warmia and Mazury Oncology Centre, Olsztyn, Poland
Head of Department: Andrzej Lachowski, MD
Porcelain gallbladder is rare manifestation of chronic cholecystitis. Calcification of the gallbladder wall is present between 0.06%-0.8% of cholecystectomy specimens. The pathogenesis is still unknown but it is believed that it caused by irritation the gallbladder by stones which lead to chronic inflammation associated with calcium deposit. Calcification of the gallbladder wall is associated with risk of gallbladder cancer.
The author of this article presented a case of a woman who was admitted to the hospital because of suspicion tumor of gallbladder. The patient underwent open cholecystectomy during which porcelain gallbladder was removed. The author performed a literature review on porcelain gallbladder.
Porcelain gallbladder is rare manifestation of chronic cholecystitis. Calcification of the gallbladder wall is present between 0,06-0,8% of cholecystectomy specimens (1, 2). The pathogenesis is still unknown but it is believed that it caused by irritation the gallbladder by stones which lead to chronic inflammation associated with calcium deposit. Calcification is five times more common in female than in men population (3). Mean age of diagnosed porcelain gallbladder is 54 years (range 38-70 years) (3). Calcification of the gallbladder wall is associated with risk of gallbladder cancer. The carcinogenesis in calcified gallbladder probably follows the metaplasia – dysplasia – carcinoma sequence.
A 62-year-old white lady referred to the department due to a suspicion tumor of gallbladder diagnosed in ultrasound examination. The patient has reported pain in the right hypochondrium region. She had no any other symptoms, drug abuse and there was no history of weight loss and loss of appetite. She had two surgeries – first due to uterine myomas and total hysterectomy due to cervical cancer. There was history of carcinoma in patient family – mother suffered from anal canal cancer.
On physical examination, in the right hypochondrium patient reported pain. There were no peritoneal symptoms. Blood tests were normal. There was no histopathological examination of the fine-needle aspiration biopsy before planned surgery.
An ultrasound examination showed thickened gallbladder wall with a diameter of 9 mm with a focus on the nature of the tumor in the wall with a diameter of about 8 mm. Computer tomographic scan (CT scan) revealed calcified gallbladder wall with dense intraductal calcification.
The patient was taken to the operating room for an open cholecystectomy. During the surgical exploration claimed calcification of the gallbladder wall. Porcelain gallbladder was removed (fig. 1-3). The material was sent for routine histopathological examination. The time of surgery was about 45 minutes.
Fig. 1. Porcelain gallbladder after cholecystectomy.
Fig. 2. Calcification of the gallbladder wall – view from the fundus.
Fig. 3. Porcelain gallbladder – view from the neck.
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zaakceptowano do druku: 2014-05-08
Adres do korespondencji:
General Surgery Consultant Faculty of Medicine, Department of Surgical Oncology University of Warmia and Mazury, Olsztyn
37 al. Wojska Polskiego, 10-228 Olsztyn
tel.: +48 505-818-126
e-mail: email@example.comNew Medicine 2/2014
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