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The most common tumour of the gall bladder is
adenocarcinoma.
Although it is not one of the more frequent cancers, it
is not rare, being incidentally found in 2% of patients who undergo
gallbladder surgery.
Because
this cancer is usually associated with cholelithiasis and chronic
cholecystitis, it is considerably more common in women than men.
Populations
that have a high incidence of cholelithiasis, have a high risk of
carcinoma of the gallbladder.
Adenocarcinomas
account for 90% of gallbladder carcinomas and are
characterized by glands lined by cuboidal or columnar cells,
which may contain mucin.
They may be well,
moderately, or poorly differentiated, depending on the
degree of gland formation.
There are several
histologic variants of adenocarcinoma recognized:
papillary ,
intestinal,
mucinous ,
signet ring cell
, and
clear cell.
Many tumours contain more than one histologic
variant.
Symptoms produced by the tumour are
similar to those encountered with gallstone disease.
However, by the time the tumour becomes
symptomatic, it is almost invariably incurable, the 5-year survival
rate being less than 3%.
For practical purposes, surgical cure
is obtained only in patients who undergo cholecystectomy for
gallbladder disease and in whom the cancer is an accidental finding.
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