Malignant Gallbladder and Biliary Tree

A

General Considerations

• 1.

  In the United States, 1.2 cases per 100,000 people annually; worldwide, sixth most common gastrointestinal tumor and represents more than 80% of biliary tumors

• 2.

  Found in 0.1%–0.5% of all cholecystectomy specimens

• 3.

  Associated with gallstones in more than 90% of cases

• 4.

  Increased incidence in certain ethnic groups—Alaskan, Native Americans

• 5.

  Other factors—porcelain gallbladder, cholecystenteric fistulas, anomalous pancreaticobiliary junction, inflammatory bowel disease, Mirizzi syndrome

• 6.

  Male/female ratio of 1:2

• 7.

  Adenocarcinoma—most common cell type; 82% of cases

• 8.

  Grave prognosis, with 5-year survival rates of less than 5% in untreated patients and median overall survival less than 6 months; 50% of patients with lymph node disease at time of diagnosis

B