Cancer Res Treat.  2011 Mar;43(1):71-74.

Calcified Carcinoma of the Gallbladder with Calcified Nodal Metastasis Presenting as a Porcelain Gallbladder: A Case Report

Affiliations
  • 1Department of Radiology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 2Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 3Department of Pathology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. esnam2003@yahoo.co.kr

Abstract

Porcelain gallbladder is regarded as a risk factor of gallbladder cancer. A porcelain gallbladder with calcified regional lymph nodes was found using computed tomography (CT) and magnetic resonance imaging (MRI) in a 43-year-old man who presented with nausea, vomiting, and abdominal pain. His cholecystectomy specimen showed diffuse wall thickening and contained small gallstones. Histological examination revealed diffuse infiltrative adenocarcinoma with extensive intratumoral calcification (calcified carcinoma). The majority of the calcified material was located within or replaced the tumor glands, and was not found in the stroma. A lymph node was totally replaced with a calcified metastatic adenocarcinoma. To the best of our knowledge, only one case of calcified lymph node metastasis from a calcified carcinoma of the gallbladder has been previously reported in the literature. We herein add a case of calcified carcinoma of the gallbladder with calcified lymph node metastasis, presenting as a porcelain gallbladder on CT and MRI.

Keyword

Gallbladder; Carcinoma; Metastasis; Lymph node; Calcification; Computed tomography; Magnetic resonance imaging

MeSH Terms

Abdominal Pain
Adenocarcinoma
Adult
Cholecystectomy
Dental Porcelain
Gallbladder
Gallbladder Neoplasms
Gallstones
Humans
Lymph Nodes
Magnetic Resonance Imaging
Nausea
Neoplasm Metastasis
Risk Factors
Vomiting
Dental Porcelain

Figure

  • Fig. 1 (A) Unenhanced computed tomography scan showed circumferential calcification in the thickened wall of the gallbladder (arrowheads) and extensive calcified regional lymph nodes (arrows). Multiple punctuated hyperdense lesions, which were found to be gallstones, were also noted inside the gallbladder lumen (small arrow). (B) T2-weighted magnetic resonance image at 9000/1200 (TR/TE) demonstrated areas of signal void in the gallbladder wall (arrowheads), within enlarged lymph nodes (arrows), and inside the gallbladder lumen (small arrow).

  • Fig. 2 (A) Histological examination of the resected gallbladder revealed denuded mucosa and infiltrative, well-differentiated adenocarcinoma with numerous fine to coarse calcifications. The majority of the calcified material was located within or replaced the tumor glands, and not found in the stroma (H&E, ×40). (B) Histological examination of the regional lymph node revealed metastatic adenocarcinoma with calcification (H&E, ×40).


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