It may be picked up incidentally on a scan done for other purposes or in a biopsy of the gall bladder after it was removed for some other indication commonly stones. Whenever Ultrasound picks up some suspicious features in gall bladder, a contrast CT scan can give more information. Needle test or biopsy is not always necessary if imaging features are reasonably suggestive and disease is still in the purview of operability.
To ensure that there is no spread to other regions, a PET CT can help give detailed information. Endoscopic ultrasound may be useful in assessing the local area and the adjacent lymph nodes. MRI scan (MRCP) may be needed in presence of jaundice to map the biliary channel and locate the extent of the block.
If considered operable, laparoscopic (key hole) assessment can help rule out spread which is low volume and too small to be picked up on PET CT scan.
Tumour markers are blood tests which can help understand the prognosis of the cancer and for follow-up assessment. Serum CA 19-9 is the most commonly used tumour marker. It needs to interpreted with caution especially in presence of jaundice.
