[Diagnostic and oncologic updating on gallbladder papilloma. Personal experience and review of the literature].
After a correct definition of the pathologic meaning of "papilloma of gallbladder" and the considerations about the main epidemiologic, pathogenetic and diagnostic guidelines, the authors discuss the meaning of the apparent higher frequency of this pathology in the biliary tract than in the gallbladder localization. This condition probably derives from the precocious appearance of pain or jaundice during choledocal pathology respects to the asymptomatic gallbladder localization. Moreover, using morphological indicators of intracholecistic ultrasonography, the gallbladder's polypoid lesions are divided in group s and for each of the m are indicate d most/actual curative criteria. Currently tendency is to check periodically gallbladder polypoid lesions, and to recure to surgery when the lesion result large more than 1 cm, single, associated with stones, when the patient is older than 50 years and when there is a clear clinical symptomatology. Finally, the authors discuss the malignance evolution of these lesions attaching importance as prognostic role to the study of the K-ras and p-53 proto-oncogenes, because they consider the carcinogenesis like a "multi-step" evolution.
Cattedra di Chirurgia Generale, Università degli Studi G. D'Annunzio, Chieti.
M
M
Di Rienzo
A
A
Annunziata
A
A
Russo
M
M
Bartolacci
E
E
Leombruni
N
N
Picardi
D000328:Adult; D017081:Cholecystectomy, Laparoscopic; D002765:Cholecystography; D005260:Female; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D010212:Papilloma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011127:Polyps / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014463:Ultrasonography