Saikia K, Xu Z, Azordegan N, Ahsan BU. Incidental diagnosis of gallbladder carcinoma during or after routine cholecystectomy: A retrospective study with emphasis on clinicopathologic findings. World J Clin Oncol 2025; 16(7): 104663 [DOI: 10.5306/wjco.v16.i7.104663]
Corresponding Author of This Article
Beena Umar Ahsan, MD, Assistant Professor, Department of Pathology and Laboratory Medicine, Henry Ford Health, 2799 W Grand Boulevard, Detroit, MI 48202, United States. bahsan1@hfhs.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Jul 24, 2025; 16(7): 104663 Published online Jul 24, 2025. doi: 10.5306/wjco.v16.i7.104663
Incidental diagnosis of gallbladder carcinoma during or after routine cholecystectomy: A retrospective study with emphasis on clinicopathologic findings
Kasturi Saikia, Zhengfan Xu, Nazila Azordegan, Beena Umar Ahsan
Kasturi Saikia, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
Zhengfan Xu, Nazila Azordegan, Beena Umar Ahsan, Department of Pathology and Laboratory Medicine, Henry Ford Health, Detroit, MI 48202, United States
Beena Umar Ahsan, Department of Medicine, Michigan State University College of Human Medicine, East Lansing, MI 48823, United States
Author contributions: Saikia K was responsible for methodology, data analysis, writing the original draft; Xu Z was responsible for data collection, statistical analysis; Azordegan N was responsible for conceptualization, literature review, manuscript editing, supervision; Ahsan BU was responsible for conceptualization, literature review, study design, manuscript editing, supervision.
Institutional review board statement: The study was approved by the Institutional Review Board of Henry Ford Health, Detroit, MI, United States.
Informed consent statement: The waiver of consent was requested due to retrospective nature of the study.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Beena Umar Ahsan, MD, Assistant Professor, Department of Pathology and Laboratory Medicine, Henry Ford Health, 2799 W Grand Boulevard, Detroit, MI 48202, United States. bahsan1@hfhs.org
Received: December 27, 2024 Revised: March 8, 2025 Accepted: June 18, 2025 Published online: July 24, 2025 Processing time: 207 Days and 12.8 Hours
Abstract
BACKGROUND
Cholecystectomy is a common surgical procedure routinely performed for patients with benign gallbladder disease. The most common indications for cholecystectomy are acute or chronic cholecystitis with or without cholelithiasis. However, in rare instances, incidental findings ranging from benign to malignant conditions are encountered, of which gallbladder adenocarcinoma is an aggressive and fatal disease.
AIM
To determine the prevalence of all incidental diagnoses in routinely performed cholecystectomy specimens, with a particular emphasis on adenocarcinoma, and to characterize the clinicopathological characteristics of malignant postoperative specimens.
METHODS
The electronic medical record and institutional pathology database were searched for analyses done on gallbladder specimens from patients who had a routine cholecystectomy for benign gallbladder disease during the study period (February 2000 to February 2023). A total of 30678 cholecystectomies performed across the study period were included for analysis. Patients who had preoperative findings or radiological results concerning malignancy were excluded. The demographic and clinical data including patient age and gender, preoperative diagnosis, radiographic results at time of diagnosis, gross and morphologic features of gallbladder specimens, and pathologic staging parameters according to the American Joint Committee on Cancer were recorded.
RESULTS
Of the 30678 cholecystectomy specimens received by the Department of Pathology from patients with who had cholecystectomy for putative benign gallbladder disease during the study period, 42 (0.14%) were determined to be incidental gallbladder adenocarcinoma and 1 was adenocarcinoma in situ. There were 2 benign incidental diagnoses, including 9 patients (0.02%) with accessory/ectopic liver lobe, and 3 with paraganglioma.
CONCLUSION
Thorough histopathological examination of routine gallbladder specimens is important to provide an early diagnosis of unexpected gallbladder cancer to ensure that patients receive timely care when the disease is treatable.
Core Tip: The most common indication for cholecystectomy is acute or chronic cholecystitis with cholelithiasis. However, in rare instances, incidental findings ranging from benign to malignant conditions can be encountered. We performed a retrospective cross-sectional study of patients who had cholecystectomies at our institution for presumed benign gallbladder disease. Our aim was to determine the prevalence of all incidental diagnoses, with a particular emphasis on adenocarcinoma, resulting from pathological analysis of gallbladder specimens in patients for whom malignancy was not suspected preoperatively. This is one of the largest studies for the incidental diagnosis of gallbladder adenocarcinoma with emphasis on histopathologic analysis.
