Virginia Research Day 2025

Medical Student Research Case Reports

12 Gallbladder Cancer with Metastastsis to the Liver: Mass Effect and its Potential Downstream Effects

Shreya Ganta; Anthony Peyton; Daood Choudry; Jace Schertler; Katherine Kim; Shivani Mody; Dr. Jonathan Millard Corresponding author: sganta@vcom.edu

Edward Via College of Osteopathic Medicine

Gallbladder cancer is rarely found in the general population, accounting for approximately one percent of all cancer. However, it is clinically significant due to its predominantly late-stage diagnosis. The 5-year relative survival rate for gallbladder cancer is 69% if it remains localized, 28% if regional metastasis is present, and 3% if distant metastasis is present. The primary aim of this report is to provide a detailed description of mass effect via the liver in the unique setting of a cadaveric dissection of a 70-year-old, female anatomical donor. The cause of death of the donor was known to be gallbladder cancer with metastasis, but the extent of the metastasis was obscured until routine dissection of the abdominal viscera. The gallbladder itself was not present in the donor and hypothesized to have been surgically removed antemortem. However, the liver was found to

be enlarged to almost twice its expected size and with spotted discolored lesions. Upon visual inspection, the liver had enlarged resulting in compression of the stomach and displacement of the right kidney and a significant portion of the colon inferiorly. The right kidney was found just superior to the right iliac fossa. Known consequences of mass effect seen in the abdomen are visible swelling and compression or loss of function in surrounding organs. Due to the extent of mass effect seen in this specific case, the extensive displacement of the kidney could lead to downstream displacement of the ureters. This could have resulted in difficulty passing urine and the left kidney having to compensate for decreased efficacy in the right kidney . In addition to the kidney, significant

compression of the colon, specifically the ascending and transverse colon, were noted. This suggests that the liver could have been a source of external bowel obstruction, leading to decreased nutrient absorption in the large intestine. Significant compression of the fundus, cardia, and body of the stomach were also noted, which could have significant impacts on food storage and digestion. Correlated symptoms of mass effect in the abdomen found in the literature further mention bloating, pain, loss of appetite, constipation or diarrhea, nausea, unintentional weight changes, and blood in the urine or rectum. Through this case report, we seek to present the visible impacts of mass effect as well as its potential downstream consequences.

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