The Role of Imaging Methods and CDX2 Immunostaining in Diagnosis and Prognosis of Gallbladder Carcinoma: An 8th Year’s Study in a Tertiary Care Center

(1) Background: Gallbladder carcinoma (GBC) represents a tumor with an unfavorable prognosis because of late discovery and a 5-year survival of 5-10%; the diagnosis is based on CT scan or MRI, but half of the cases are accidentally discovered after cholecystectomy (occult cases). Transabdominal ultrasound (TUS) lacks sufficient accuracy for the diagnosis, however, high-resolution examination and the introduction of contrast-enhanced ultrasound (CEUS) has increased the performance in gallbladder carcinoma detection and characterization (2) Methods: We performed an observational, retrospective study that included all patients with gallbladder carcinoma admitted to the Craiova County Emergency Clinic Hospital between January 1, 2017, and December 31, 2024; patients with no pathological confirmation, and those with insufficient data were excluded. (3) Results: 40 cases of gallbladder carcinoma were diagnosed; TUS sensitivity was lower, but specificity was similar to that of the CT scan. CEUS was suggestive of GBC in 5 cases and was false positive in another case. The survival for gallbladder tumors was poor, with 32.5% 1-year and 10.5% 5-year survival. CDX2 immunostaining was positive in 50% of the 10 tested stage III carcinomas and was associated with a higher median survival. (4) Conclusions: Gallbladder carcinomas are rarely encountered (50% being occult cases) and harbor a dismal prognosis.