Kasle D, Rahnemai-Azar AA, Bibi S, Gaduputi V, Gilchrist BF, Farkas DT. Carcinoma in situ in a 7 mm gallbladder polyp: Time to change current practice? World J Gastrointest Endosc 2015; 7(9): 912-915 [PMID: 26240692 DOI: 10.4253/wjge.v7.i9.912]
Corresponding Author of This Article
Daniel T Farkas, MD, FACS, Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, 1650 Selwyn Ave, Suite 4E, New York, NY 10457, United States. dfarkas@bronxleb.org
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jul 25, 2015; 7(9): 912-915 Published online Jul 25, 2015. doi: 10.4253/wjge.v7.i9.912
Carcinoma in situ in a 7 mm gallbladder polyp: Time to change current practice?
David Kasle, Amir A Rahnemai-Azar, Shahida Bibi, Vinaya Gaduputi, Brian F Gilchrist, Daniel T Farkas
David Kasle, Amir A Rahnemai-Azar, Shahida Bibi, Brian F Gilchrist, Daniel T Farkas, Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, New York, NY 10457, United States
Vinaya Gaduputi, Department of Medicine, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, New York, NY 10457, United States
Author contributions: Kasle D and Bibi S collected the data and drafted the article; Gaduputi V drafted the article; Rahnemai-Azar AA contributed to the conception, design, the data acquisition and the critical revision; Gilchrist BF made the critical revision; Farkas DT contributed to the conception, design, drafting article, the critical revision, and made the final approval.
Institutional review board statement: This study was considered exempt by the Bronx-Lebanon Institutional Review Board.
Informed consent statement: Informed consent was obtained from the patient for publication in this case report.
Conflict-of-interest statement: None of the authors have a conflict of interest or financial disclosure to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Daniel T Farkas, MD, FACS, Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, 1650 Selwyn Ave, Suite 4E, New York, NY 10457, United States. dfarkas@bronxleb.org
Telephone: +1-718-9601225 Fax: +1-718-9601370
Received: March 25, 2015 Peer-review started: March 28, 2015 First decision: April 10, 2015 Revised: April 27, 2015 Accepted: May 26, 2015 Article in press: May 27, 2015 Published online: July 25, 2015 Processing time: 131 Days and 12.1 Hours
Abstract
Detection of polypoid lesions of the gallbladder is increasing in conjunction with better imaging modalities. Accepted management of these lesions depends on their size and symptomatology. Polyps that are symptomatic and/or greater than 10 mm are generally removed, while smaller, asymptomatic polyps simply monitored. Here, a case of carcinoma-in-situ is presented in a 7 mm gallbladder polyp. A 25-year-old woman, who had undergone a routine cholecystectomy, was found to have an incidental 7 mm polyp containing carcinoma in situ. She had few to no risk factors to alert to her condition. There are few reported cases of cancer transformation in gallbladder polyps smaller than 10 mm reported in the literature. The overwhelming consensus, barring significant risk factors for cancer being present, is that such lesions should be monitored until they become symptomatic or develop signs suspicious for malignancy. In our patient’s case this could have led to the possibility of missing a neoplastic lesion, which could then have gone on to develop invasive cancer. As gallbladder carcinoma is an aggressive cancer, this may have led to a tragic outcome.
Core tip: Current guidelines for management of gallbladder polyps recommend cholecystectomy for polyps with size > 10 mm and/or presence of symptoms. Considering some cases of carcinoma in polyps with size less than 10 mm have been seen, consideration of a cholecystectomy for smaller size polyps is warranted.
