[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Liver and gallbladder](https://durgical.com/en/general-pathology/areas/liver/) › Gallbladder carcinoma

# Gallbladder carcinoma

- Lesion

Gallbladder cancer grows in a gallbladder inflamed by stones for many years; it is often found late, sometimes by chance after surgery.

Updated Nov 12, 2026

## Key points

- Gallstones present in most cases; the risk rises with large stones and long duration.
- Other risks: porcelain gallbladder, gallbladder polyps of ten millimetres or more, abnormal pancreaticobiliary junction, chronic Salmonella carriage.
- Infiltrating type (diffuse wall thickening) is more common than exophytic.
- Microscopy: adenocarcinoma, sometimes papillary or mucinous; adenosquamous and squamous variants occur.
- Early direct invasion of the liver; spread to cystic and hilar nodes, peritoneum, lungs.
- Common in Andean and Latin American women; an incidental finding after cholecystectomy for stones.

## What it is

Carcinoma of the gallbladder is the most common malignancy of the extrahepatic biliary tract. It is more frequent in women and in some populations of Latin America (Chile, Bolivia and other Andean areas) and South Asia. Gallstones are present in most cases, and chronic inflammation drives a dysplasia-carcinoma sequence. Most tumours are adenocarcinomas that infiltrate the wall and liver early, so prognosis is poor unless found incidentally at an early stage.

## Structure

- Gross: diffuse grey-white thickening of the wall or a papillary mass, usually with stones; may invade the liver.
- Micro: glands of malignant columnar cells in desmoplastic stroma; perineural and lymphatic invasion.

## Step by step

- Stones and chronic inflammation injure the mucosa for years.
- Repeated regeneration favours metaplasia (pyloric or intestinal) and mutations (TP53, KRAS, ERBB2).
- Low-grade dysplasia progresses to high-grade dysplasia and carcinoma in situ.
- Invasive adenocarcinoma infiltrates the thin wall, which has no submucosa.
- The tumour invades the liver bed and spreads to lymph nodes and peritoneum.

## Markers

- Keratin 7
- CEA
- CA 19-9 (serum)
- HER2 (ERBB2) in some

## Clinical notes

- Symptoms resemble gallstone disease: pain, then jaundice, weight loss and a mass when advanced.
- Pathologists examine every cholecystectomy specimen because early carcinomas are often unsuspected.

## Memory aid

Stones that stay for decades leave a scar, and sometimes a cancer: the gallbladder pays for its chronic inflammation.

## Test yourself

Think of the answer, then tap the question to see it.

## What is the main risk factor for gallbladder carcinoma?

Long-standing gallstones with chronic cholecystitis.

## Why does gallbladder carcinoma invade the liver early?

The gallbladder wall is thin, lacks a submucosa and lies directly on the liver bed.

## In which regions is gallbladder cancer especially common?

Andean South America (such as Chile and Bolivia) and parts of South Asia, with high rates in women.

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## Connections

## Related 5

- [Gallstones: cholesterol vs pigment](https://durgical.com/en/general-pathology/gallstones-cholesterol-vs-pigment/)
- [Cholecystitis: acute, acalculous and chronic](https://durgical.com/en/general-pathology/cholecystitis-acute-acalculous-and-chronic/)
- [Cholangiocarcinoma](https://durgical.com/en/general-pathology/cholangiocarcinoma/)
- [Precancerous conditions: when chronic inflammation, metaplasia or hyperplasia raise the risk](https://durgical.com/en/general-pathology/precancerous-conditions-when-chronic-inflammation-metaplasia-or-hyperplasia-rais/)
- [Pathologic calcification: dystrophic vs metastatic](https://durgical.com/en/general-pathology/pathologic-calcification-dystrophic-vs-metastatic/)

## Related conditions 3

- [Gallbladder cancer](https://durgical.com/en/conditions/gallbladder-cancer/)
- [Gallstones (cholelithiasis)](https://durgical.com/en/conditions/gallstones/)
- [Typhoid (enteric) fever](https://durgical.com/en/conditions/typhoid-fever/)

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Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: [Gallbladder Carcinoma](https://www.ncbi.nlm.nih.gov/books/NBK442002/) (StatPearls (NCBI Bookshelf), 2024).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/general-pathology/gallbladder-carcinoma/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/gallbladder-carcinoma/