Gallbladder cancer )Symptoms Same as gallstone disease ◆ Recurrent ruq pain a) Radiating to interscapular area ausea c) Vomiting d) Fatty food intolerance
Gallbladder Cancer ➢Symptoms ◆Same as gallstone disease ◆Recurrent RUQ pain a) Radiating to interscapular area b) Nausea c) Vomiting d) Fatty food intolerance
Gallbladder cancer-Nevein staging Stage I: intramucosal only (癌组织仅限于粘膜内,即原位癌) Stage l: involvement of mucosa and muscularis (侵及肌层) Stage I: involvement of all three layers (癌组织侵及胆囊壁全层) Stage IV: involvement of all three layers and the cystic lymph node (侵及胆囊壁全层合并周围淋巴结转移) Stage V: invol vement of liver by direct extension or metastases, or metastases to any other organ (直接侵及肝脏或转移至其他脏器或远处转移) JE Nevin, TJ Moran, S Kay, R King. Cancer, 1976
Gallbladder Cancer-Nevein staging ◆ Stage I: intramucosal only; (癌组织仅限于粘膜内，即原位癌) ◆ Stage II: involvement of mucosa and muscularis; (侵及肌层) ◆ Stage III: involvement of all three layers; (癌组织侵及胆囊壁全层) ◆ Stage IV: involvement of all three layers and the cystic lymph node; (侵及胆囊壁全层合并周围淋巴结转移) ◆ Stage V: involvement of liver by direct extension or metastases, or metastases to any other organ (直接侵及肝脏或转移至其他脏器或远处转移) JE Nevin, TJ Moran, S Kay, R King. Cancer, 1976
Gallbladder Cancer -TNM staging Primary tumor (T) Primary tumor cannot be assessed No evidence of primary tumor Carcinoma in situ Tumor invades lamina propria or muscular layer la Tumor invades lamina propria T1b Tumor invades muscular layer Tumor invades perimuscular connective tissue: no extension beyond serosa or into liver Tumor perforates the serosa(visceral peritoneum) and/or directly invades the liver and/or one other adjacent organ or structure, such as the stom- ach, duodenum, colon, pancreas, omentum, or extrahepatic bile ducts Tumor invades main portal vein or hepatic artery or invades two or more extrahepatic organs or structures Regional lymph nodes(N) Regional lymph nodes cannot be assessed No regional lymph node metastasis Metastases to nodes along the cystic duct, common bile duct, hepatic artery, and/or portal vein Metastases to periaortic, pericaval, superior mesentery artery and/or celiac artery lymph nodes Distant metastasis (M) No distant metastasis M1 Distant metastasis Stage grouping Stage O Tis Stage T3 MO tage IlIB T1-3 N1 MO Stage IVA No-1 MO Any T Any N M1 Edge SB. et al. AjCC cancer staging hand book: from the ajcc cancer staging manual. 7th ed. New York: 2010
Gallbladder Cancer-TNM staging Edge SB, et al. AJCC cancer staging handbook: from the AJCC cancer staging manual. 7th ed. New York: 2010
Gallbladder cancer )Diagnosis a) Ultrasonography is often the first diagnostic modality used in the evaluation of patients with right upper quadrant abdominal pain A heterogeneous mass replacing the galbladder lumen and an irregular gallbladder wall are common sonographic features of gallbladdercancer. b)CT scan usually demonstrates a mass replacing the gallbladder or extending into adjacent organs c) Cholangiography also may be helpful in diagnosing jaundiced patients with gallbladder cancer The typical cholangiographic finding in gallbladder cancer is a long stricture of the common hepatic duct
Gallbladder Cancer ➢Diagnosis a) Ultrasonography is often the first diagnostic modality used in the evaluation of patients with right upper quadrant abdominal pain. A heterogeneous mass replacing the gallbladder lumen and an irregular gallbladder wall are common sonographic features of gallbladder cancer. b) CT scan usually demonstrates a mass replacing the gallbladder or extending into adjacent organs. c) Cholangiography also may be helpful in diagnosing jaundiced patients with gallbladder cancer. The typical cholangiographic finding in gallbladder cancer is a long stricture of the common hepatic duct