Gallbladder Cancer Clinical Presentation

  • Author: Mary Denshaw-Burke, MD, FACP; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
 
Updated: Sep 14, 2015
 

History

The symptoms of gallbladder cancer overlap with the symptoms of gallstones and biliary colic. Abdominal pain may be of a more diffuse and persistent nature than the classic right upper quadrant pain of gallstone disease. Jaundice, anorexia, and weight loss often indicate more advanced disease.

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Physical

See the list below:

  • Jaundice
  • Palpable mass in the right upper quadrant (Courvoisier sign, if this is due to a palpable gallbladder)
  • Periumbilical lymphadenopathy (Sister Mary Joseph nodes)
  • Left supraclavicular adenopathy (Virchow node)
  • Pelvic seeding: Mass is palpated on digital rectal examination (Blumer shelf).
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Causes

See Pathophysiology. Associated conditions include the following:

  • Chronic gallstones
  • Calcification of the gallbladder (porcelain gallbladder) - 10-25% incidence of gallbladder cancer
  • Crohn ileocolitis
  • Ulcerative colitis
  • Occupational chemical exposure
  • Estrogens
  • Typhoid carriers
  • Anomalous pancreatobiliary duct junction
  • Gallbladder polyps
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Contributor Information and Disclosures
Author

Mary Denshaw-Burke, MD, FACP Clinical Assistant Professor of Medicine, Jefferson Medical College of Thomas Jefferson University; Clinical Assistant Professor, Affiliated Clinical Faculty of the Lankenau Institute for Medical Research; Program Director of Hematology/Oncology Fellowship, Education Coordinator for Oncology, Lankenau Medical Center

Mary Denshaw-Burke, MD, FACP is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Andrew Scott Kennedy, MD Physician-in-Chief, Radiation Oncology

Andrew Scott Kennedy, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for Cancer Research, American Society for Radiation Oncology, Radiological Society of North America, Americas Hepato-Pancreato-Biliary Association, American Society of Clinical Oncology

Disclosure: Nothing to disclose.

Jessica Katz, MD, PhD, FACP Senior Medical Director, Immuno-Oncology, Oncology R&D, GlaxoSmithKline

Jessica Katz, MD, PhD, FACP is a member of the following medical societies: American College of Physicians, American Society of Clinical Oncology

Disclosure: for: Currently employed at GSK.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Benjamin Movsas, MD 

Benjamin Movsas, MD is a member of the following medical societies: American College of Radiology, American Radium Society, American Society for Radiation Oncology

Disclosure: Nothing to disclose.

Chief Editor

N Joseph Espat, MD, MS, FACS Harold J Wanebo Professor of Surgery, Assistant Dean of Clinical Affairs, Boston University School of Medicine; Chairman, Department of Surgery, Director, Adele R Decof Cancer Center, Roger Williams Medical Center

N Joseph Espat, MD, MS, FACS is a member of the following medical societies: Alpha Omega Alpha, American Association for Cancer Research, American College of Surgeons, American Medical Association, American Society for Parenteral and Enteral Nutrition, American Society of Clinical Oncology, Americas Hepato-Pancreato-Biliary Association, Association for Academic Surgery, Central Surgical Association, Chicago Medical Society, International Hepato-Pancreato-Biliary Association, Pancreas Club, Sigma Xi, Society for Leukocyte Biology, Society for Surgery of the Alimentary Tract, Society of American Gastrointestinal and Endoscopic Surgeons, Society of Surgical Oncology, Society of University Surgeons, Southeastern Surgical Congress, Southern Medical Association, Surgical Infection Society

Disclosure: Nothing to disclose.

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A schematic drawing of the extent of lymphadenectomy for gallbladder cancer, especially when the extrahepatic biliary tree is resected.
 
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