Unresectable Moderately Differentiated Gallbladder Adenocarcinoma in an Adolescent: A Case Report.

Gallbladder carcinoma (GBC) is a relatively rare disease of old age with adenocarcinoma being the most prevalent subtype. It is extremely rare in childhood and adolescence, and only a few cases have been reported to date. A 15-year-old boy presented in the outpatient department referred from the periphery with dull progressive right upper quadrant abdominal pain, associated with jaundice, abdominal distension, anorexia and significant weight loss for the past three months. The patient's medical history was inconclusive. Laboratory evaluations revealed obstructive jaundice. Imaging showed an infiltrative mass at the porta hepatis which upon biopsy demonstrated a moderately differentiated gallbladder adenocarcinoma. Percutaneous transhepatic biliary drainage (PTBD) was done for symptom relief. Chemotherapy with a combination of gemcitabine and carboplatin was opted with palliative intent. After three cycles the patient still showed no response, so the chemotherapy was stopped and only symptomatic treatment was continued. Urgent provision of medical care upon the development of symptoms, early sonographic diagnosis and timely cholecystectomy along with adjuvant chemotherapy are crucial in significantly prolonging survival and reducing patient suffering. Gene panel testing and chemosensitivity assay further optimize treatment and help in better understanding of disease.