Bony Secondaries and Dissemination in Advance Carcinoma Gallbladder: A Longitudinal Study

Context:Metastasis in carcinoma gall bladder is uncommon and occurs late in the course of the disease. Of all the distant sites that can be involved, the skeletal system is the least common site. We hereby present a prospective longitudinal study depicting the incidence, type, predisposing site and time of presentation of skeletal metastasis in carcinoma gallbladder. Aims:The present study provides new and important information regarding skeletal metastases which may be more common with the introduction of laparoscopic cholecystectomy and should be excluded before radical resection is contemplated.Settings and Design:This study was carried from 2010 to 2014. The study was approved by the review board and ethical committee of Institute of Medical Sciences, Banaras Hindu University Varanasi.Methods and Material:After systemic examination, 95 patients of histopathologically proven and ultrasonographically diagnosed cases of carcinoma gallbladder (GBC) were subjected to contrast enhanced volumetric CT examination of abdomen and pelvis.Statistical Analysis Used:Data were analyzed using the Statistical Package for Social Sciences (SPSS 16, Chicago, IL, USA).Results:Four cases were found metastasizing to bones. In case of lumbar vertebral and iliac wing involvement the lesions were hyperdense suggesting osteoblastic metastasis. Osteolytic lesion was noted involving dorsal vertebra. Ala of sacrum showed mixed type of metastasis. All cases were seen in advanced stage of carcinoma.Conclusion:To our knowledge, till date no longitudinal study has been done to assess incidence, type (osteolytic or osteoblastic or mixed), predisposing site and time of presentation (stage) of skeletal metastasis in GBC. The present study provides new and important information regarding the aggressive behaviour of GBC from an endemic geographical zone.