September 1995, Volume 45, Issue 9

Letter to the Editor

Primary Carcinoma of the Gall Bladder - A 5 Year Experience

Dear Madam, Carcinoma of the gall bladder is one of the common cancers seen in females in Pakistan. We report the frequency of carcinoma gall bladder seen in the Sind Lab. Pathology Laboratory and Blood Bank, Karachi, during a five year period between 1st January, 1990 to 31st December, 1994. A total of 18140 surgical pathology specimens were received, during the study period. Six hundred and seventy seven cases (3.7%) were of gall bladder. Carcinoma of the gall bladder was diagnosed in thirty one cases (4.6%). Twenty-six (83.9%) patients with carcinoma gall bladder were females and five(16.1%) males with the be female to male ratio being 5:1. The average age of the carcinoma gall bladder patients was 57.8 years. Maximum number of the patients were between the ages of fifty and sixty years (67.7%). The youngest patient, was 35 years and the oldest 85 years, both being females. Histologically twenty-nine cases (93.6%) were adenocarcinomas. One was a carcinoma in-situ of the squamous variety and another squamous cell carcinoma. Of 31 carcinoma gall bladder cases, sixteen (51 .6%) had gall stones, while in the remaining 15 cases, this association could not be confirmed as the specimens had been cut open and the records did not indicate the presence of stones. A study in Rawalpindi/lslamabad1 showed gall stones in all gall bladder carcinoma cases. A geographical variation is seen regarding the association of carcinoma gall bladder with gall stones. A study in Tanzania2 showed an association of 40%, in Taipei3 65% whereas in U.K.4 and France5 a co relation of 85% and 86% respectively was found.
Factors leading to a high frequency of carcinoma gall bladder in our population are worth investigating. Planned prospective studies to this effect would provide a good data base for which detailed intraoperative findings should be submitted to the histopathologist

Asif Bhurgri, Yasmin Asif and I. A. Khawaja*
Dept. of Pathology, Dow Medical College and The Sindh Lab, Karachi*.


1. Rashid, A., Hassan, H. Carcinomagall bladder-A study of 73 consecutivecases at Rawalpindi/Islamabad. Pak. J. Path., 1993;4(1):53.55.
2. Amir H., Kirei, B. Primary carcinoma ofthegall bladder in Tanzania. A twenty year review. Centr Afr. J. Med., 1990;36(7): 164.6.
3. Hsieh, i. P., Tsao.W. L.. Tang, H. S. etal. Primary carcinoma of the gall bladder: A review of 10 years experience at Tri- Service General Hospital. Chung.Hua­I-Hsueh-Tsa-Chih-Taipei., 1993; 51(3):193-9.
4. Ouchi. K., Suzuki, M., Saijo, S. et al. Do recent advances in diagnosis and operative management improve the outcome of gall bladder carcinoma? Surgexy.,1993 ;113(3)324-9.
5. Cuberafond, P.. Gainant. A.. Cucchiaro, G. Surgical treatment of 724 carcinoma of the gall bladder. Result of French Surgical Association Survey, Ann. Surg. 1994;Mar,219(3) 275-80.

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