Porcelain Gallbladder: Often an Overlooked Entity
15 April 2017
31 July 2017
14 September 2017 (online)
Background Porcelain gallbladder (GB) is a rare but potentially premalignant condition with minimal symptoms. Accident and Emergency (A&E) departments often tend to investigate abdominal pain through plain radiographs, which are occasionally reported by radiologists, thereby leaving behind few uncommon conditions, such as porcelain gallbladder unreported.
Objectives We present three cases of porcelain GB in which initial diagnosis was not considered due to the presence of various other calcifications in the upper abdomen.
Methods In A&E, plain abdominal X-rays were routinely performed in all three patients to investigate nonspecific postprandial abdominal pain. Although GB calcification was easy to diagnose on plain films, it was initially overlooked to be a cause of the symptoms and later was diagnosed on abdominal CT scans, performed for further evaluation.
Results Abdominal X-rays revealed thin curvilinear calcification in the GB wall, partially calcified neck and body, and gall stones. CT scan confirmed porcelain GB in all three patients.
Conclusion Gallbladder mural calcification is a rare cause of nonspecific abdominal pain, which is often overlooked on plain abdominal X-rays causing missed diagnosis. The association of porcelain GB with adenocarcinoma entails special emphasis on timely diagnosis and prompt management.
- 1 Gupta S, Misra S. Rare presentation of malignant porcelain gallbladder with intrahepatic ductal calcification and surgical obstructive jaundice. Indian J Surg Oncol 2012; 3 (01) 44-46
- 2 Pilgrim CH, Groeschl RT, Christians KK, Gamblin TC. Modern perspectives on factors predisposing to the development of gallbladder cancer. HPB (Oxford) 2013; 15 (11) 839-844
- 3 Fadare O, DeMartini SD. Eosinophilic dysplasia of the gallbladder: a hitherto undescribed variant identified in association with a “porcelain” gallbladder. Diagn Pathol 2006; 1: 15
- 4 Subramaniam RVS, Karthikeyan VS, Sistla SC. , et al. Porcelain gall bladder in a case of papillary renal cell carcinoma: a rare occurrence and its impact on treatment verdict. Clin Cancer Invest J 2012; 1 (04) 230-232
- 5 Stephen AE, Berger DL. Carcinoma in the porcelain gallbladder: a relationship revisited. Surgery 2001; 129 (06) 699-703
- 6 Machado NO. Porcelain gallbladder: decoding the malignant truth. Sultan Qaboos Univ Med J 2016; 16 (04) e416-e421
- 7 Khan AN. Porcelain Gallbladder. Available at: http://emedicine.medscape.com/article/372582-overview ; 2013. Accessed September 5, 2017
- 8 Igami T, Usui H, Ebata T. , et al. Single-incision laparoscopic cholecystectomy for porcelain gallbladder: a case report. Asian J Endosc Surg 2013; 6 (01) 52-54