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LETTER TO THE EDITOR
Year : 2012  |  Volume : 8  |  Issue : 4  |  Page : 653-654

Gall bladder cancer in a child: A rare occurrence


Department of Surgical Oncology, Dr. BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

Date of Web Publication29-Jan-2013

Correspondence Address:
Ashwin A Kallianpur
Department of Surgical Oncology, Dr. BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.106593

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How to cite this article:
Muduly DK, Satyanarayana Deo SV, Shukla NK, Kallianpur AA, Prakash R, Jayakrishnan T. Gall bladder cancer in a child: A rare occurrence. J Can Res Ther 2012;8:653-4

How to cite this URL:
Muduly DK, Satyanarayana Deo SV, Shukla NK, Kallianpur AA, Prakash R, Jayakrishnan T. Gall bladder cancer in a child: A rare occurrence. J Can Res Ther [serial online] 2012 [cited 2019 Sep 20];8:653-4. Available from: http://www.cancerjournal.net/text.asp?2012/8/4/653/106593

Sir,

We report a case of carcinoma of gallbladder in a 15-year-old boy, who presented to the outpatient clinic with a history of pain in the right hypochondrium since last 3 months and jaundice since last 1 month with occasional fever, chills and rigor. He had a history of loss of appetite since last 3 months. There was no history of any change in bowel or bladder habits. Also, there was no personal or family history of any hematological disease. On general examination, he was ECOG 3 with no supraclavicular lymphadenopathy. On clinical abdominal examination, his gallbladder was palpable, smooth, firm with rounded margins and moving with respiration. Liver was enlarged 5 cm below the costal margins. His hemoglobin was 10.7 gm%, bilirubin 3.6 gm%, AST 102 IU/L, ALT 208 IU/L, ALP 599 IU/L and albumin 4.6 gm%. Ultrasonography of the abdomen showed a mass lesion in fundus and body of gall bladder. Contrast-enhanced CT scan of abdomen and pelvis revealed a mass lesion in the fundus and body of gallbladder with invasion of segment IV and V of liver and multiple metastases throughout the liver parenchyma with invasion of second part of duodenum [Figure 1], [Figure 2]. There was extensive lymphadenopathy along the hepatoduodenal ligament, peripancreatic, retroduodenal and celiac axis. He was a resident of Ganga river belt in northern India, which is a high risk region for carcinoma of gallbladder. [1] With the above history, clinical findings and imaging, a clinical diagnosis of carcinoma of gall bladder was made. FNAC of the lesion was suggestive of carcinoma. He was planned for supportive therapy in view of poor general condition and extensive disease and he died after 3 months of diagnosis.

The most common age group affecting gallbladder cancer is after 40 years. Malignancy of the gallbladder is extremely rare in children with just two case reports available in English literature and few in non-English literature. [2],[3],[4] The most causative factor cited for carcinoma of gallbladder is gall stones, but this patient did not had any gallstone or hemolytic disorder predisposing for gall stones. [1] Gall bladder cancer has been found to be linked with chronic infection with Helicobacter bilis and Salmonella typhi. Because of extremely rare occurrence and fatality of the disease, any gallbladder mass lesion should be evaluated for possibility of malignancy and treated in a multimodality protocol.
Figure 1: CT scan of abdomen showing mass lesion replacing the gallbladder and infiltrating the liver. There is a separate metastatic lesion in segment VIII of liver

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Figure 2: CT scan of abdomen showing mass in gallbladder with extensive necrotic lymphadenopathy in retroduodenal, retropancreatic region

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 > References Top

1.Nandakumar A, Gupta PC, Gangadharan P, Visweswara RN, Parkin DM. Geographic pathology revisited: Development of an atlas of cancer in India. Int J Cancer 2005;116:740-54.  Back to cited text no. 1
    
2.Rudolph R, Cohen JJ. Cancer of the gallbladder in an 11-yr-old Navajo girl. J Pediatr Surg 1972;7:66-7.  Back to cited text no. 2
    
3.Iwai N, Goto Y, Taniguchi H, Tokiwa K, Tsuto T, Yanagihara J, et al. Cancer of the gallbladder in a 9-year-old girl. Z Kinderchir 1985;40:106-7.  Back to cited text no. 3
    
4.De Aretxabala X, Roa I, Araya JC, Burgos L, Flores P, Wistuba I, et al. Gallbladder cancer in patients less than 40 years old. Br J Surg 1994; 81:111.  Back to cited text no. 4
    


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