Moderately Differentiated Adenocarcinoma G2


My mother recently went through Gallbladder Lap. Chole. And pathology report revealed Moderately Differentiated G2 Adenocarcinoma. Oncoligist further suggested few tests including PET CT Scan and the results are below. CA19.9------16.42 CA-125------16.9 CEA------1.49 PET SCAN findings revealed Metabolically active INTRA-thoracic lymph nodes are concerning for Metastatic disease. Hypermetabolic lymph node measures 11mm is observed in descending aorto-esopageal recess likely Metastatic. Now what should be next procedure? Is it curable. I am attaching the reports.


MBBS, Diplomate American Board in Medical Oncology, Diplomate American board in Hematology, Diplomate American board in Medicine. | Lahore

Thank you for the information. It's not curable. If she is in good physical condition,  she could be treated with chemotherapy and it helps some patients .


Post Owner

At what stage her cancer is? How much time she has medically?

4 weeks ago


MBBS, AFSA (Medical Oncology), DMRT | Lahore

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Thank you for your mail.As a matter of fact decision is not straight  forward.Since a couple active lymph nodes are localised on PET then lymphadenetomy( removal of lymph nodes and sending for histopathology to prove it is a metastatic disease ) if not then no need for chemotherapy.If positive yes.But it is quite difficult surgery at times.The other approach is to give chemotherapy and Radiotherapy (for local area of gall bladder surgery). After completing chemotherapy perform PET again to see results.if ok means no active nodes then follow  with PET or CT over the period of 5 years.  


Post Owner

At what stage her cancer is? how much time she has medically?

4 weeks ago


MBBS, DMRT, Mbeth | Karachi

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Very complex situation. Disease is metastasised, but if patients general condition is good , she can be given chemotherapy,,, unfortunately chances are not very high.


Post Owner

Thanks doc. For your valuable input. At what stage her cancer is?

4 weeks ago



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Its stage 4. I agree with the opinion of all the other learned oncologist


The guideline for gallbladder cancer surgery is wide local excision with removal of all related lymph nodes. In this case laparoscopic surgery was done and lymph nodes were not recovered in pathological specimen. PET Scan revealed metastatic thoracic lymph nodes. These lymph nodes should be confirmed for mets. (but it is v difficult). Otherwise chemotherapy can be given, which will be some helpful.


MBBS, MD, MCPS (Medicine), FCPS (Medical Oncology), Member of European Society of Medical Oncology | Faisalabad

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It's very interesting. Usually disease go nearby Lymph nodes but in this case metabolic activity is found intra thoracic. if we consider it as metastasis, cure is not possible unfortunately but there are new drugs available which can shrink this cancer and let patient live some longer

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