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Case of the Week 318



What's the most likely diagnosis?

  • 68 year old female with loss of appetite



Contrast-enhanced axial CT of mid-abdomen

  1. Hemangiomas of the liver
  2. Nephrocalcinosis
  3. Pancreatic pseudocyst
  4. Carcinoma in a porcelain gallbladder
  5. Liver laceration

Additional Image - Contrast-enhanced axial CT of liver

 

Additional Image

Contrast-enhanced axial CT of liver


Answer:


4. Carcinoma in a porcelain gallbladder, metastatic to the liver

More (Click Discussion Tab)


Carcinoma of the Gallbladder

General Considerations

  • Uncommon adenocarcinoma affecting patients in their 60’s or older with long-standing cholelithiasis
  • Female predominance
  • Associated with
    • Cholelithiasis or choledocholithiasis in 70-90% (most often cholesterol stones)
    • Calcification of the wall (Porcelain gallbladder)
      • Carcinoma occurs in 25% of porcelain gallbladders
    • Congenital biliary cysts
    • Chronic Salmonella infections
    • Anomalous junction of the pancreatic and biliary ducts
    • Smoking
    • More common in Native Americans

More ...


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LearningRadiology.com is an award-winning educational site aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of case quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, cardiac, and bone radiology.