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Gallbladder carcinoma (GBC) is an uncommon malignancy with a high mortality rate. Detecting gallbladder carcinoma in its early stages can be difficult, despite improvements in ultrasound and computed tomography (CT) imaging. Most diagnoses of GBC are made at advanced stages, with the majority being found incidentally during surgery for cholelithias...
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Background-Cholecystectomy specimen (gallbladder) is the most frequently encountered surgical specimen in a histopathology laboratory. It shows different histopathological changes ranging from inflammation to premalignant changes and carcinoma. Incidental detection of gallbladder cancer in cholecystectomy specimen has been reported in 0.3 to 2% of...
Citations
... Routine bloods and tumour markers are not specific and sensitive to GB ca, with certain cases showing an obstructive picture if the tumour invades the biliary tract [8]. Majority of cases were diagnosed at advanced stages, and most are found incidentally during elective surgery for cholelithiasis [9]. Survival outcome of this disease depends on the tumour stage, which will affect the prognosis of the patient and the subsequent mode of management including palliative surgery in advanced cases. ...
Background: Sarcomatoid carcinoma, a rare malignancy, is difficult to diagnose preoperatively, and often presents at a late stage with poor clinical outcome. The most common histology subtype of gallbladder (GB) carcinoma is adenocarcinoma which accounts for more than 70% of all GB tumors histologically. Sarcomatoid carcinoma of the gallbladder accounts for less than 1% of all subtypes, and there are only 109 cases reported worldwide. Case presentation: A 64 year old gentleman presented with right hypochondriac pain for 2 weeks, with a palpable mass clinically over the right hypochondriac region. Initial Imaging suggested gallbladder empyema, and was treated with antibiotics for a week, but pain was unresolved, and subsequently underwent laparoscopic cholecystectomy, which turned out to be sarcomatoid carcinoma under histopathological examination. Conclusion: Sarcomatoid carcinoma can only be diagnosed via histopathology as there are no substantiate screening tools available for now.
... Gallbladder cancer (GBC), a common malignant tumor in digestive system, has a high mortality rate and lacks diagnostic specificity, which leads to a great challenge of preoperative and early-stage diagnosis. [1] Although GBC is identified as a relatively rare tumor, it shows extensively poor prognosis. [2] Currently, surgical resection remains the mainstay for the treatments of GBC patients, such as laparoscopic cholecystectomy, radical mastectomy, and extended radical mastectomy, and the latter 2 methods are more effective to improve prognosis. ...
Background
This study is supposed to investigate the effects of combined epidural and general anesthesia on intraoperative hemodynamic responses, postoperative cellular immunity, and prognosis in patients with gallbladder cancer (GBC).
Methods
One hundred forty-four GBC patients were selected and randomly divided into the general anesthesia (GA) group and the combined epidural-general anesthesia (CEGA) group. Before anesthesia induction (t0), at intubation (t1), at the beginning of surgery (t2), 5 minutes after pneumoperitoneum (t3), at the end of surgery (t4), after recovery of spontaneous breathing (t5), after regaining consciousness (t6), and after extubation (t7), the heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and the depth of anesthesia (bispectral index [BIS]) were detected. Blood samples were separately collected 30 minutes before anesthesia induction (T1), 2 hours after the beginning of surgery (T2), at the end of surgery (T3), 1 day after surgery (T4), 3 days after surgery (T5). The survival rates of T cell subsets (CD3+, CD4+, CD8+, CD4+/CD8+) and natural killer (NK) cells were determined by flow cytometry. Postoperative nausea and vomiting (PONV), visual analog scale (VAS), and sedation-agitation scale (SAS) were performed to assess postoperative adverse reactions. A 3-year follow-up was conducted.
Results
Compared with the GA group, the CEGA group had significant lower SBP values at t5 and t6, lower DBP values at t1, t3, t4, and t5, lower HR values at t1 and t5, and higher BIS values at t4, t5, t6, and t7. No PONV was observed in the CEGA group. In comparison to the GA group, the VAS was markedly increased and survival rates of CD3+, CD4+, and CD4+/CD8+ cells were increased at T2, T3, T4, and T5 in the CEGA group. The 1-year, 2-year, and 3-year survival rates were not evidently different between the CEGA group and the GA group.
Conclusion
Our study provides evidence that the combined epidural-general anesthesia might attenuate intraoperative hemodynamic responses and improve postoperative cellular immunity, so that it might be a more available anesthesia method for GBC patients.
Objective The purpose of the study was to investigate the potential added value of 18F-FDG-PET/MRI (functional information derived from PET) over standard diagnostic liver MRI (excellent soft tissue characterization) in diagnosing and staging suspected primary hepatobiliary malignancies including extrahepatic cholangiocarcinoma (ECC), intrahepatic cholangiocellular carcinoma (ICC) and gallbladder cancer (GBCA).
Methods Twenty consecutive patients with suspected hepatobiliary malignancy were included in this retrospective study. All patients underwent combined whole-body (WB) 18F-FDG-PET/MRI including contrast-enhanced MRI of the liver, contrast-enhanced WB-MRI and WB 18F-FDG-PET. Two experienced readers staged hepatobiliary disease using TNM criteria: first based on MRI alone and then based on combined 18F-FDG-PET/MRI. Subsequently, the impact of FDG-PET/MRI on clinical management compared to MRI alone was recorded. Histopathologic proof served as the reference standard.
Results Hepatobiliary neoplasms were present in 16/20 patients (ECC n = 3, ICC n = 8, GBCA n = 5), two patients revealed benign disease, two were excluded. TNM staging with 18F-FDG-PET/MRI was identical to MRI alone in 11/18 (61.1 %) patients and correctly changed the stage in 4/18 (22.2 %), resulting in a change in management for 2/4 patients (11.1 %). 18F-FDG-PET/MRI was false-positive in 3/18 cases (16.7 %). Both MRI and 18F-FDG-PET/MRI were falsely positive in 1 case without malignancy.
Conclusions A small incremental benefit of 18F-FDG-PET/MRI over standard MRI of the liver was observed. However, in some cases 18F-FDG-PET/MRI may lead to false-positive findings. Overall there is seemingly limited role of 18F-FDG-PET/MRI in patients with suspected hepatobiliary malignancy.
Targeted T1–T2 MRI contrast agents, which can eliminate the difficulty of image matching across multiple imaging instruments and permit specific localization of lesions, are promising candidates for more accurate diagnosis of tumors. In this study, ultrasmall [email protected]3O4 nanoparticles were designed and synthesized as T1–T2 dual-mode MRI contrast agents for accurate tumor imaging. First, to investigate the influence of nanoparticle size, [email protected]3O4 nanoparticles with diameters of 4, 8, and 12 nm were prepared, among which the 8 nm 3-(3,4-dihydroxyphenyl)propionic acid (DHCA)-modified nanoparticles exhibited the optimal T1–T2 dual-mode MRI performance. Next, to develop a tumor-targeted contrast agent, the [email protected]3O4 nanoparticles were conjugated with the F56 peptide, which targets the vascular endothelial growth factor receptor, and the resulting [email protected]3O4 nanoparticles were found to exhibit good T1–T2 dual-mode imaging and tumor-targeting performance both in vitro and in vivo, indicating the nanoparticles represent a new research tool for accurate tumor diagnosis.
