Adenocarcinoma de vesícula biliar

Abstract

Adenocarcinoma is a neoplasm that originates in the cells of the epithelium that lines the exocrine glands. Adenocarcinoma of the gallbladder has an incidence of 3% of malignant tumors and ranks fifth in the neoplasms of the digestive tract. The age of presentation ranges between 65-75 years and it is estimated that 90% of patients are older than 50 years. It is more frequent in the female sex with a ratio of 1.5 - 11: 1, this is justified with the higher incidence of cholelithiasis in women. However, its low incidence and silent behavior prevent timely diagnosis and treatment. The objective of this clinical case is to emphasize the importance of a timely referral for adequate specialized treatment in patients with adenocarcinoma of the gallbladder. It is a female patient of 59 years of age, mestizo, hypertensive and with a family history of gastric cancer and cirrhosis, she went to the emergency service of the Hospital of the Ecuadorian Social Security Institute of Riobamba for abdominal pain in the upper right hypochondrium of great intensity. it radiates to the scapular region of a month of evolution that is accompanied by nausea that does not reach vomiting. Abdominal ultrasound revealed the presence of gallbladder stones with thickening of the walls, compatible with acute lithiasic cholecystitis, so it was decided to perform a laparoscopic cholecystectomy with good postoperative evolution. One month later, he returned to emergency due to severe pain in the right hypochondrium that did not give analgesics plus jaundice and febrile spikes. A computerized axial tomography of the abdomen was performed, which reported a subhepatic collection. The histological report of gallbladder determined an adenocarcinoma, concordant with the presence of elevated tumor markers plus risk factors. The patient was referred for oncology management but died shortly after discharge.