Porcelain Gallbladder

During an evaluation to detect metastatic disease in a 75-year-old woman with recently diagnosed cecal cancer, a CT scan of the abdomen and pelvis revealed an incidental finding of a heavily calcified gallbladder (arrow). No metastases were found. The patient had no symptoms related to gallbladder disease. Virendra Parikh, MD, of Fort Wayne, Ind, notes that a porcelain gallbladder— or intramural calcification of the gallbladder wall—frequently progresses (in up to 20% of patients) to gallbladder carcinoma. The diagnosis can be made by plain abdominal radiographs or CT scans.¹ Prophylactic cholecystectomy is therefore indicated to prevent development of carcinoma. This patient underwent colon resection and cholecystectomy. At the time of surgery, the gallbladder was firm and heavily calcified. Histopathologic examination of gallbladder tissue did not show any malignancy.