A team from Rochester, Minnesota, USA, determined the prevalence of gallbladder cancer in primary sclerosing cholangitis (PSC) patients.
The case records of all patients with PSC undergoing a cholecystectomy at the authors' institution, between 1977 and 1999, were reviewed.
Of the 102 patients with PSC who underwent a cholecystectomy, 14% had a gallbladder mass.
In the subset of patients with gallbladder masses, 8 of 14 (57%) had adenocarcinomas (7 primary adenocarcinomas and 1 metastatic cholangiocarcinoma).
The other 6 had benign masses (5 adenomas and 1 cholesterol polyp).
In those patients with benign masses, 33% were found to have associated epithelial cell dysplasia.
|Gallbladder neoplasms malignant in 40-60% of PSC cases.|
|American Journal of Gastroenterology|
Whereas, in patients with primary gallbladder cancers, 57% had associated dysplasia.
The team found that patients with primary gallbladder adenocarcinoma had a favorable outcome after cholecystectomy, with a 36-month survival of 66%.
Dr Daniel C. Buckles, of the Mayo Medical School, Clinic, and Foundation, Rochester, said on behalf of his group, "Gallbladder neoplasms in PSC patients are malignant in approximately 40-60% of the cases.
"The presence of gallbladder epithelial cell dysplasia suggests a dysplasia-carcinoma sequence in PSC, similar to that observed in ulcerative colitis."
"Consideration should be given to performing a cholecystectomy in PSC patients with gallbladder polyps.
"If a cholecystectomy is not performed, careful interval follow-up is warranted," he concluded.