ADENOCARCINOMA GALL BLADDER MASQUERADING AS COLONIC MALIGNANCY

DR SANKAR NARAYANAN ML; DR SANKAR SUBRAMANIAN; DR THANKA JOHNSON; DR SUSRUTHAN MURALITHARAN; DR SAHIL BASSI

Volume : VIII, Issue : III, March - 2018

ADENOCARCINOMA GALL BLADDER MASQUERADING AS COLONIC MALIGNANCY

Dr Sankar Narayanan Ml, Dr Sankar Subramanian, Dr Thanka Johnson, Dr Susruthan Muralitharan, Dr Sahil Bassi

Abstract :

Gall bladder carcinoma is well known for its asymptomatic onset most commonly diagnosed in the post operative biopsy following a cholecystectomy. Early diagnosis is the key for a better prognosis and the most important denominator in the surgical management that determines the outcome is to achieve a microscopic negative resection margin.

In clinical practice almost all cases present at an advanced stage (locally / metastatic) as the disease is asymptomatic in the early course. Locally advanced cases may involve the adjacent organs like the liver, bile duct, duodenum and colon which warrant multi organ resection to achieve microscopic negative resection margin.

Colonic involvement though reported in carcinoma gall bladder, a proliferative intra luminal growth with anemia is extremely rare totally masquerading as a primary colonic malignancy. In such scenario when the anatomical origin of tumor is doubtful, immunohistochemical technique plays a pivotal role to arrive at the diagnosis. Gall bladder carcinoma has dismal prognosis, radical surgery might offer survival benefits for early stages.

We report a case of atypical presentation of gall bladder carcinoma, the diagnostic challenges and the role of immunohistochemistry to arrive at the diagnosis.