Department of Surgery, Maulana Azad Medical College, New Delhi, India.
Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, India.
BMC Surg. 2021 Mar 16;21(1):133. doi: 10.1186/s12893-021-01117-2.
Gall bladder cancer (GBC) is the fifth most common malignancy in the gastrointestinal system and the most common malignancy of the biliary system. GBC is a very aggressive malignancy having a 5 year survival rate of 19%. Giant Gall Bladder (GGB) is an uncommon condition that can result from cholelithiasis or chronic cholecystitis and rarely with malignancy.
A 65 year old lady presented with vague abdominal pain for 12 years and right abdominal lump of size 20 × 8 cms was found on examination. CT scan showed a circumferentially irregularly thickened wall (2.5 cm) of gall bladder indicative of malignancy. Per-operatively a GB of size 24 × 9 cm was noted and patient underwent radical cholecystectomy. It was surprise to find such a giant malignant GB with preserved planes. Histopathology, it was well differentiated adenocarcinoma of gall bladder of Stage II (T2a N0 M0).
It is known that mucocoele of GB can attain large size, however chronic cholecystitis will lead to a shrunken gall bladder rather than an enlarged one. A malignant GB of such size and resectable is rare without any lymph node involvement or liver infiltration. Few cases of giant benign gall bladder have been reported in literature, however this appears to be the largest resectable gall bladder carcinoma reported till date as per indexed literature.
Giant GB is an uncommon finding. They are mostly benign, however malignant cases can occur. Radiological findings may suggest features of malignancy and define extent of disease. Prognosis depends on stage of disease and resectability, irrespective of size.
胆囊癌（GBC）是胃肠道系统中第五种最常见的恶性肿瘤，也是胆道系统中最常见的恶性肿瘤。GBC 是一种非常侵袭性的恶性肿瘤，5 年生存率为 19%。巨大胆囊（GGB）是一种不常见的疾病，可由胆石症或慢性胆囊炎引起，很少与恶性肿瘤有关。
一名 65 岁女性因腹痛 12 年就诊，体检发现右腹部肿块大小为 20×8 厘米。CT 扫描显示胆囊壁呈环形不规则增厚（2.5 厘米），提示恶性肿瘤。术中发现胆囊大小为 24×9 厘米，行根治性胆囊切除术。令人惊讶的是，如此巨大的恶性胆囊仍保留有正常的解剖平面。组织病理学检查显示为 II 期（T2a N0 M0）分化良好的胆囊腺癌。
已知胆囊粘液囊可增大到很大的尺寸，然而慢性胆囊炎会导致胆囊缩小而不是增大。如此大尺寸且可切除的恶性胆囊而无淋巴结转移或肝浸润是罕见的。文献中报道了少数巨大良性胆囊的病例，但根据索引文献，这似乎是迄今为止报道的最大可切除胆囊癌病例。
巨大胆囊是一种不常见的发现。它们大多是良性的，但也可能发生恶性病例。影像学表现可能提示恶性肿瘤的特征，并确定疾病的范围。预后取决于疾病的分期和可切除性，与大小无关。
