Ultrasonography in carcinoma of the gallbladder. Diagnostic difficulties and pitfalls.

Gallbladder carcinoma (GBCA) is difficult to diagnose in its early stage by ultrasound (US) due to the non-specificity of various characteristics. In an investigation of 25 female patients (mean age 68.2 years) all with a histologic diagnosis of primary GBCA (adenocarcinoma) and a US examination prior to that, the correct diagnosis was only established in 11. The sensitivity was thus low (44%). The inability to differentiate GBCA from chronic cholecystitis (contracted gallbladder with stones) makes this US finding hazardous, and implicates a considerable risk of overlooking malignancy. A cholecystectomy without delay in these patients may lead to the discovery of further cases of GBCA in early stages.