Incidental detection of gallbladder carcinoma in third trimester of pregnancy

Abstract

Gall bladder cancer (GBC) represents the most common biliary tract cancer. GBCs are diagnosed more frequently in women. GB cancer represents a progression from dysplasia, to carcinoma in situ, to invasive carcinoma over about 15 years. Severe dysplasia and carcinoma in situ have been found in more than 90% of gallbladders that contain GB cancer. A 35-year-old G₂P₁L₁ @34.4 weeks with previous 1 lower segment caesarean section (LSCS) came to emergency referred from a primary health center in view of pain abdomen. She was worked up and was found out to have deranged liver functions but no visible icterus, ultrasound whole abdomen showed GB mass with multiple heterogenous hypoechoic round to oval targeted lesions largest measuring 3.5×3 cm suggestive of metastasis. Patient was taken up for LSCS at 36 weeks. Post-operative period was uneventful until day 3 when patient started complaining of pain epigastrium with mild abdominal distention. Contrast enhanced computed tomography (CECT) was done which proved it to be a metastatic GB cancer. GB cancer during pregnancy is rare but challenging to manage. Diagnostic imaging, like ultrasound is mostly the safest and first line approach. The prognosis of stage 4 gallbladder cancer in pregnancy depends on various factors, including the extent of metastasis, the patient’s overall health, and the timing of diagnosis and treatment. Generally, stage 4 gallbladder cancer has a poor prognosis, with low survival rates even outside of pregnancy.