This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Gallbladder, Subject name: Surgery
All of the following are true about incidental finding in a female patient of age 56 years who underwent the CECT abdomen except: 
Select and explain. 
A. May be seen on plain X-ray, B. More commonly diagnosed on CT, C. It is an indication for cholecystectomy, D. Always denotes benign etiology
D: Always denotes benign etiology
Answer: D: Always denotes benign etiology 
Explanation: The given image is of Porcelain Gallbladder . Porcelain GB is characterized by extensive calcium encrustation of GB wall Clinical Features Most porcelain GB (90%) are associated with gallstones High frequency association (10%) is with GB adenocarcinoma Diagnosis Generally diagnosed incidentally on X-Ray or CT. Treatment Cholecystectomy is all patients with porcelain GB (high incidence of development carcinoma GB)