Introduction
Gall 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.