[Mirizzi syndrome and gallbladder cancer]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Hepatobiliary Surgery

Background:

• Mirizzi syndrome (MS) is a rare complication of gallstone disease, characterized by extrinsic compression of the common hepatic duct by impacted stones in the cystic duct or gallbladder neck.
• The incidence of gallbladder cancer (GBC) in patients with MS is debated, with some studies suggesting a higher prevalence compared to general gallstone patients.

Observation:

• This case series presents two patients diagnosed with Mirizzi syndrome type II, a specific subtype involving significant inflammation and potential erosion into the common bile duct.
• Both patients were concurrently diagnosed with advanced gallbladder cancer, staged at T4N1M0 and T3NxMx, respectively.

Findings:

• The findings highlight a potential association between Mirizzi syndrome and the development or delayed diagnosis of gallbladder cancer.
• The advanced stages of cancer at diagnosis in these MS patients underscore the challenges in early detection.

Implications:

• Early recognition of Mirizzi syndrome may warrant increased vigilance for underlying gallbladder malignancy.
• Further research into the pathogenetic mechanisms linking MS and GBC is crucial for improving diagnostic strategies and patient outcomes.
• Multidisciplinary management, integrating surgical, oncological, and radiological expertise, is essential for addressing complex cases of MS with concurrent GBC.