Infomedica, No 147 (2009)

ATYPICAL CLINICAL MANIFESTATIONS OF GALLBLADDER CARCINOMA

Zizi Niculescu, Laura Mazilu, Mihaela Ghinea, Mihaela Hâncu, Gabriela Lilios

Abstract


Abstract:
Gallblader cancer (GBC) is the most common of the biliary tract malignancies, accounting for approximately 5.000 newly diagnosed cases in the United States [1]. GBC is diagnosed most frequently in individuals between 70 and 75 years and shows a 3/1 predilection for women over men [2]. The greatest risk factor for the development of GBC is the presence of gallstones [3]. Patients often present with nonspecific symptoms, such as abdominal pain, weight loss, anorexia, nausea, acute cholecystitis, and jaundice. Up to 20% of cancers are diagnosed incidentally at the time of gallblader surgery. No specific laboratory or marker tests are available to assist in making the diagnosis. Unfortunately most patients with GBC are diagnosed in advanced, inoperable stages. Patients with unresectable or metastatic tumors may benefit from a regimen of 5-fluorouracil or gemcitabine-based chemotherapy, but survival remains extremely poor [4]. We present the case of a 53-year old woman admitted in Clinical Department of Internal Medicine II, complaining mainly of respiratory simptoms, and who was later diagnosed with gallblader cancer.

Manifestãri clinice atipice în neoplasmul de veziculã biliarã
Rezumat:
Cancerul de veziculã biliarã (VB) reprezintã cea mai frecventã neoplazie a tractului biliar, incidenta în USA fiind de ~ 5.000 de cazuri noi/an [1]. Diagnosticul este mai frecvent la pacientii cu vârste cuprinse între 70 si 75 de ani, iar raportul femei/bãrbati este de 3/1 [2]. Cel mai important factor de risc pentru cancerul VB este reprezentat de litiaza biliarã [3]. Pacientii se prezintã frecvent cu simptome nespecifice si anume durere abdominalã, scãdere ponderalã, anorexie, greatã, colecistitã acutã si icter. Un procent de pânã la 20% din cazuri este diagnosticat incidental cu ocazia interventiilor chirurgicale efectuate pe VB. Deasemenea, algoritmul de diagnostic nu include markeri sau teste specifice. Din pãcate majoritatea cancerelor VB sunt diagnosticate în stadii avansate, nerezecabile. Tratamentul pacientilor cu tumori nerezecabile sau metastatice, constã în chimioterapie cu regimuri pe bazã de 5-fluorouracil sau gemcitabinã, dar supravietuirea rãmâne extrem de scãzutã.

Cuvinte cheie: cancerul de veziculã biliarã, litiazã
biliarã, simptome respiratorii.

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