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Table of Content - Volume 3 Issue 3- September 2016


 


Adenocarcinoma of gall bladder with a skip lesion in common bile duct- A case report

 

Yoshitha Siripurapu1*, Praveen Kumar Vasanthraj2, Ananda Kumar Balasubramanian3, Venkata Sai4

 

1,2,3,4Resident, Department of Radiology and Imaging Sciences, Sri Ramachandra University, Porur, Chennai, Tamilnadu-600116, INDIA.

Email: yoshitha.siripurapu16@gmail.com

 

Abstract              Background: Malignancies of the gall bladder are uncommon with poor prognosis. The five year survival rate is less than 5% and patients usually present late due to non specific signs and symptoms. Gall bladder carcinoma commonly metastasize with direct spread or lymphnode spread. It is uncommon for a carcinoma of gall bladder to spread into the biliary system with normal intervening segment. Case presentation: We report a case of skip malignant deposit in extrahepatic biliary tree with primary carcinoma involving the fundus and body of the gall bladder and the intrapancreatic portion of the common bile duct (CBD). A 45 year female patient with no comorbidities presented to our department with clinical features of obstructive jaundice, abdominal pain and vomiting. After initial evaluation, radiological investigations were asked revealed. Radiological evaluation revealed asymmetric wall thickening involving the fundus and body of the gall bladder with wall thickening noted involving the intrapancreatic segment of the distal common bile duct (approxiamtely 2-2.5 cm from ampulla). The patient underwent a pancreaticoduodenectomy, and histopathological examination revealed moderately differentiated adenocarcinoma with signet ring cell formation of the gall bladder and the intrapancreatic portion of the CBD. Conclusion: Simultaneous malignancies of the biliary tree have been rarely reported, therefore, it is essential for ideal imaging to maintain a high index of suspicion while evaluating such lesions and to look for the presence of primary tumors or metastasis

Key Words: Adenocarcinoma, biliary malignancies, common bile duct, field cancerization, gall bladder, lymphovascular invasion, skip phenomenon.