Diwan Shrestha

and 5 more

IntroductionGall bladder carcinoma is a rare neoplasm and is the fifth most common gastrointestinal malignancy with an incidence of 1 to 2 per 100,000 in the US and 22 per 100,000 in women in Delhi.(1) However, it is usually diagnosed at an advanced stage with an overall median survival of less than 6 months as the gall bladder has a thin wall, narrow lamina propia, and single muscular layer. It usually presents in the 6th to 7th decade of life with a female-to-male ratio of 3.4:1.(2) Only 0.3 to 3% of patients develop gall bladder carcinoma, although approximately sixty-nine to eighty-six percent of patients have a gallstone disease history. Other risk factors of carcinoma gallbladder include porcelain gallbladder, Mirizzi syndrome, ethanol & tobacco abuse, gallbladder polyp size > 10mm, anomalous pancreaticobiliary duct junction, and chronic infection with Salmonella typhi. Sixty percent of the tumor arises from the fundus of the gallbladder.(3)The pathogenesis of carcinoma gallbladder follows the progression from metaplasia to dysplasia to carcinoma.Most pancreatic pseudocysts occur as a consequence of acute pancreatitis. But, they may also occur in the setting of chronic pancreatitis, postoperatively, or after pancreatic trauma. (4) One common mechanism for carcinoma of gallbladder and pancreatitis is abnormal pancreaticobiliary duct junction.(5,6) Pancreatic pseudocyst associated with gallbladder carcinoma occurs very rarely. We here present an unusual case of carcinoma of the gallbladder with a pancreatic pseudocyst.