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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
- Hemangiomas of the liver
- Nephrocalcinosis
- Pancreatic pseudocyst
- Carcinoma in a porcelain gallbladder
- 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
This Week
68 year-old female with loss of appetite and abnormal CT scan of the abdomen
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