Background: Porcelain gallbladder is characterized by calcification of the gallbladder wall, possibly associated chronic inflammation from cholelithiasis. It is unknown whether porcelain gallbladder is associated with higher rates of hypercalcemia and/or hyperparathyroidism compared to cholelithiasis without porcelain gallbladder.

Methods: We searched our patient database for patients with porcelain gallbladder on imaging and patients with cholelithiasis without porcelain gallbladder. We collected data on patient age, gender, calcium levels, parathyroid hormone (PTH) levels, and medications/comorbidities known to cause hypercalcemia.

Results: 1000 patients within our database had porcelain gallbladder on imaging. Of these, 661 (245 male) had at least one serum calcium value for analysis. These patients were matched by age and gender with 6610 patients with cholelithiasis who had at least one serum calcium value. Rates of recurrent/persistent hypercalcemia were higher among patients with porcelain gallbladder at 16.8% versus 11.1% (p < 0.01). Rates of hyperparathyroidism were also higher among porcelain gallbladder patients at 12% versus 7.5% (p < 0.01).

Conclusion: Patients with porcelain gallbladder show higher rates of hypercalcemia and hyperparathyroidism than patients with cholelithiasis alone.

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http://dx.doi.org/10.1016/j.amjsurg.2019.10.010DOI Listing

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  • Porcelain gallbladder is a rare condition marked by calcification of the gallbladder wall, increasing the risk of gallbladder cancer and leading to high levels of the tumor marker CA19-9.
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  • Post-surgery, histopathology showed no cancer but inflammation and calcification, and CA19-9 levels normalized, emphasizing that benign conditions can elevate CA19-9 and the importance of accurate diagnosis.
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