Gallbladder cancer: an incidental neoplasm

Abstract

Gallbladder cancer is the most frequent cancer of the biliary tract worldwide with a greater predisposition for the female sex. The incidence varies according to geographic location, being the Andes region headed by Bolivia and Chile where the highest rates have been observed. It is usually diagnosed incidentally when the surgical specimen is analyzed in early stages or by its clinical manifestations in more advanced stages. Symptoms such as jaundice, pain in the right hypochondrium and weight loss may point to the diagnosis. Symptoms are usually non-specific and due to its anatomical location do not cause clinical suspicion in the early stages. It is a neoplasm with high mortality due to its late diagnosis. Approximately 30% of patients with lesions confined to the gallbladder wall will survive only 10% in 5 years. Etiology is multifactorial and will depend on the patient's predisposition and associated risk factors. Risk factors such as cholelithiasis and polyps are the most studied and most frequently linked to gallbladder cancer, however it has also been linked to porcelain gallbladder, primary sclerosing cholangitis, chronic infections of the gastrointestinal tract mainly salmonella and helicobacter, congenital biliary cysts, abnormal junction of the pancreaticobiliary duct and aberrations in specific DNA repair genes. Like many cancers its staging follows the TNM classification. Treatment will depend on staging. Surgical intervention is the fundamental element mainly in early stages either I or II. Adjuvant treatment has not proven to be effective.