TUMOR of the gallbladder is rarely diagnosed preoperatively,1 since clinical presentation and roentgenographic findings are generally indistinguishable from those of cholecystitis. Indeed, even at the time of surgery, the diagnosis is often missed because of surrounding inflammation.2
The roentgenographic demonstration of a calcified wall or an irregular mural lesion on an oral cholecystogram should raise clinical suspicion of a tumor.3 As illustrated by the case reports, ultrasound has also proved useful in preoperative identification of patients with gallbladder neoplasm.
Report of Cases
Case 1.—
A 70-year-old jaundiced woman with vomiting and a 4.5-kg weight loss was found to have a palpable mass in the right upper quadrant and gastric outlet obstruction on plain abdominal roentgenograms. Ultrasound demonstrated a complex mass in the gallbladder fossa, without defining the lumen. Bile duct dilation was also noted (Fig 1). An adenocarcinoma obliterating the gallbladder and causing biliary obstruction was discovered