A CASE OF XANTHOGRANULOMATOUS CHOLECYSTITIS MIMICKING GALLBLADDER CANCER WITH COLON INVASION

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  • 結腸浸潤を伴った胆嚢癌と鑑別困難であった黄色肉芽腫性胆嚢炎の１例

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Abstract

A 58-year-old woman was admitted to the hospital because of right hypochondralgia. An abdominal US and CT disclosed a thickened gallbladder wall with multiple cystic lesions in the fundus of the gallbladder. The level of CA19-9 was elevated. Preoperative diagnosis was chronic cholecystitis, but gallbladder cancer (GBC) was also suspicious. In operative findings, the gallbladder showed extensive adhesions to the transverse colon. Under the diagnosis of GBC with invasion to the adjacent organs, an extended cholecystectomy with partial resection of the colon was done. Histopathologic final diagnosis was xanthogranulomatous cholecystitis (XGC) without GBC. XGC presents difficulty in differential diagnosis from GBC on imagings. Intraoperative frozen-section examination is useful, but there are cases of both XGC and GBC simultaneously. Accordingly, in instances in which gallbladder cancer is suspected, we must bear a possibility of XGC in mind and select operative procedure carefully based on the imagings or intraoperative findings. It is also important to oftain an adequate informed-consent should radical surgery be needed, in case the final pathologic diagnosis is GBC.

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