Click an information source below to view the case history.
69-year-old male with increased liver enzymes. Recent ultrasound, CT of gallbladder at outside facility showed gallstones. On exam neck supple, chest clear. Abdomen soft and nontender without adenopathy.
CXR negative for malignancy.
ERCP attempted, blocked by apparent gallstone.
Diagnostic laparoscopy w/cholecystectomy and intraoperative cholangiogram. Excisional biopsy of peritoneal masses x 2.
Cholecystectomy: 2.5 cm moderately differentiated adenocarcinoma invades through muscle wall into adjacent adipose tissue. Lymphatic space invasion present. Invasive carcinoma and high grade dysplasia present at apparent cystic duct margin and within < 1.0 mm of cauterized hepatic margin. Peritoneal biopsy: poorly differentiated adenocarcinoma compatible with gallbladder lesion.
Started chemo: Gemzar.