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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


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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68 year-old female with loss of appetite and abnormal CT scan of the abdomen
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