Case 262: Gallbladder Carcinoma (primary)

Diagnostic Category:

Clinical Presentation:

51 year old woman with right upper quadrant pain.

MR: Enhancement with Gd-EOB-DTPA

Imaging Findings:

MR of the liver with Gd-EOB-DTPA demonstrates pseudo-hepatospecific enhancement of the thickened gallbladder wall, which is typical for fibrotic tissue components. Resection specimen showed invasive adenocarcinoma of the gallbladder wall with typical substantial desmoplastic stroma and focal perforation into the liver (better seen on CT). The enhancement with Gd-EOB-DTPA on the hepatobiliary phase is similar to blood pool. Compare to progressive fibrotic enhancement on CT with iodine agents, which is hyperdense to hepatic parenchyma on the equilibrium phase.

Note cholelithiasis, which is more obvious than on CT.