In 1777, Maximilian de Stoll1 described carcinoma of the gall bladder. His first case was unusual in that it occurred in a left-sided gall bladder, in a patient with situs invertus. In the second case which he described the gall bladder was like cartilage, with ulceration of the liver and involvement of the mesentery. The lesions were found at autopsy examination. Despite the infrequency of the disease, many reports have appeared. The difficulty in establishing a diagnosis, the bizarre symptoms, and the poor results of surgery have stimulated frequent studies of the disease. These reasons prompted our review of 50 patients having carcinoma of the gall bladder from St. Luke's Hospital, Chicago. INCIDENCE Carcinoma of the gall bladder is reported as occurring in 0.71% to 8.5% of all surgical gall-bladder specimens.* It is found in 0.27% to 0.34% of all autopsy examinations.† Approximately 4.5% of all malignancy deaths are