Polypoid lesion of the gallbladder: indications of carcinoma and outcome after surgery for malignant polypoid lesion.

Of 716 consecutive patients who underwent cholecystectomy, forty-four patients had preoperatively defined polypoid lesions of the gallbladder. Of these 44, 32 patients had benign polypoid lesion and the other 12 had carcinoma of the gallbladder. The aim of the present study was to evaluate the precise differentiating factors between the malignant and benign polypoid lesions and to examine the outcome of patients with polypoid carcinoma after radical surgery. The patients' sex, symptoms and the presence of gallstones were not significantly different between patients with carcinoma and those with benign polypoid lesion. However, the size (> 10 mm), number of polypoid lesion (single) and patients' age (> or = 60-yr-old) were the significant indicators of carcinoma. All but one patient with carcinoma underwent surgery and ten of twelve patients are alive at present with a mean of 6 years after surgery. The maximal size of the lesion was closely associated with the depth of invasion and carcinomas confined to the mucosal or proper muscle layer were free from lymph node metastasis. We concluded that carcinoma is highly suspected when the size of the polypoid lesion is over 10 mm, when the polypoid lesion is solitary and patient's age is over 60 years. The detection of the malignant polypoid lesion results in satisfactory outcome after surgery.