A Case Series On Incidentally Detected Gallbladder Malignancy
Conditions: Gallbladder Malignant Neoplasm
Sponsor: Osmania Medical College

 
 
A CASE SERIES ON INCIDENTALLY DETECTED GALL BLADDER 
MALIGNANCY 
 
Dr.Sathaiah Dadi*, Dr. Meghana Maria Tharakan^,  
Dr. Perugu Venkateshwar*, Dr. Swarajya^, Dr. Rithika TN*, 
 
*Upgraded Department of General Surgery, 
^Upgraded Department of Pathology, 
Osmania General Hospital, Hyderabad, Telangana, India 
 
 
Official Title of the Study:    A CASE SERIES ON INCIDENTALLY DETECTED            
GALL BLADDER MALIGNANCY ( Retrospective Analysis ) 
 
NCT number:  
Date of the document:     08-08-2022 
Study period:                   01-01-2019 to 31-12-2019 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
STUDY DESIGN, MATERIAL, AND METHODS: 
 
A retrospective analysis of hospital records of patients who underwent 
Cholecystectomy in year duration (2019) for benign conditions, diagnosed and 
confirmed histopathologically as Gallbladder Malignancy. There are a total of one 
hundred and eighty patients who underwent cholecystectomy at our hospital 
(Osmania General Hospital) in 2019; out of which seven patient’s 
histopathological diagnosis was gall bladder malignancy. We reviewed all the 
case’s history and cross-checked the histopathological slides and confirmed the 
diagnosis. To avoid the bias of covid-19 pandemic in surgical practice we 
confined the patient records to the pre-pandemic period of one-year duration 
(2019). 
 
Case Series: All the case details including the investigations and the final 
diagnosis are incorporated in the table format ( Table- 1 ) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Table- 1: Showing the details of patients diagnosed with gallbladder malignancy, and the 
final histopathological diagnosis  
 
 
 
 
 
 
 
Case 
No 
Gender Age Clinical 
presentation 
Investigations  Procedure 
done 
Histopathol
ogy 
1 
Female 60 
Right upper abdominal 
pain, yellowish 
discolouration of eyes, 
Nausea for 10days 
USG – Multiple calculi 
with max diameter 
6mm 
CT – Cholelithiasis,  
CBD diameter- 11mm 
 
ERCP stenting  
Laparoscopic 
Cholecystectomy 
Intestinal type 
metaplastic 
gallbladder 
malignancy 
2 
Male 
65 
Right upper abdominal 
pain – 20days 
 
USG – Distended 
gallbladder with no 
mass lesions and a 
hypoechoic density 
Open 
Cholecystectomy 
Adenocarcino
ma 
gallbladder 
infiltrating 
muscularis 
mucosa 
3 
Female 58 
Right upper abdominal 
pain radiating to back – 
3 days 
USG – Multiple calculi 
and a small <1cm 
polyp in the 
gallbladder 
CECT: 1*0.7cm polyp 
Laparoscopic to 
Open 
cholecystectomy 
Welldifferenti
ated 
adenocarcino
ma of gall 
bladder 
4 
Female 40 
Right upper abdominal 
pain- 20 days 
USG – 8*10mm polyp Laparoscopic 
Cholecystectomy 
Welldifferenti
ated 
adenocarcino
ma of gall 
bladder 
5 
Male 
59 
Right upper abdominal 
pain- 20 days 
Lump in the upper 
abdomen- 20 days 
USG – Distended 
gallbladder with 
Sludge 
CECT – Thickened 
gallbladder wall with 
periGB collection S/O 
Perforation 
Open Subtotal 
Cholecystectomy 
Well to 
moderately 
differentiated 
adenocarcino
ma of gall 
bladder 
6 
female 
52 
Right upper abdominal 
pain- 20 days 
USG- Distended 
gallbladder with no 
mass lesions 
Laparoscopic to 
Open 
cholecystectomy 
Welldifferenti
ated 
adenocarcino
ma of gall 
bladder 
7 
female 
55 
Right upper abdominal 
pain- 20 days 
USG – Multiple calculi 
with max diameter 
6mm 
 
Laparoscopic 
Cholecystectomy 
Welldifferenti
ated 
adenocarcino
ma of gall 
bladder 

Statistical Analysis:  
 
A total of 180 patients underwent cholecystectomy for various benign conditions in one 
year, out of which seven patients confirmed histopathologically with Gallbladder 
malignancy.  
 
Total no of 
patients 
180 
Diagnosed with 
malignancy 
7 
percentage 
3.8% 
 
Among these seven, three patients converted from laparoscopic to open procedure for 
difficulty with resection, two patients are posted for surgery considering empyema of gall 
bladder preoperatively, one patient posted in view of gall bladder perforation, and two 
patients preoperative diagnosis was gall bladder polyp. 
 
Converted from 
Lap to Open 
3 
Pre-op GB Polyp 
2 
Perforated GB 
1 
Empyema GB 
2 
 
Only one patient is 40 years old and others are more than 50 years, and two of them are 
males.  
 
Total 
7 
Percentage 
Males 
2 
28.5 
Females 5 
71.5 
 
 

Out of a total of 180 patients who underwent cholecystectomy, 117 are females and 63 are 
males 
 
 
Total 
180 
Males 
63 
Females 
117 
 
 
 
Out of 180, the age distribution is as follows  
Percentage of malignancy detected  
 
Age 
Percentage 
20 – 29 
0 
30 – 39 
0 
40 – 49 
0.005 
>50 
99.99 
 
 
It implies that the malignancy rate increases with an increase in the patient’s age more than 
50years and also with gender (Females > males)