Recurrence of gallbladder carcinoma 12 years after laparoscopic cholecystectomy.

Abstract

Owing to the widespread diffusion of laparoscopic procedures, an increasing number of unexpected gallbladder cancer has been reported. In order to improve outcome, re-resection may be required depending on the depth of invasion. Development of recurrences is usually an early event associated with poor prognosis but those occurring several years after surgery are extremely rare. In these cases, the synchronous discovery of a colon cancer may pose difficulty in the differential diagnosis of metastatic lesions. Radical surgical resection is the only chance to relieve symptoms and prolong survival in selected cases. We report a case of abdominal recurrence following resection of incidental gallbladder carcinoma (IGC), occurring 12 years after laparoscopic cholecystectomy in a patient with synchronous right colon adenocarcinoma (ADC). A 78-year-old woman was referred to our department with a two-month history of enlarging, painless mesogastric mass and fatigue. Past medical history included laparoscopic cholecystectomy for cholelithiasis twelve years before. Histology revealed papillary IGC, spreading to the submucosal layer (pT2). Open liver bed dissection and hepatoduodenal ligament lymphadenectomy were performed one month later, without evidence of residual disease. At admission, physical examination revealed a firm and