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Xanthogranulomatous cholecystitis mimicking gallbladder cancer and causing obstructive cholestasis
Paulo N Martins1, Patricia Sheiner, Marcelo Facciuto
1Department of Surgery, Transplant Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. martins.paulo@mgh.harvard.edu
Hepatobiliary & Pancreatic Diseases International : HBPD INT
|October 13, 2012
Summary
Xanthogranulomatous cholecystitis (XGC) can mimic gallbladder cancer, posing diagnostic challenges. This case highlights the importance of considering XGC in differential diagnoses, even with suspicious imaging findings, to guide appropriate surgical management.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Diagnostic Imaging
Background:
- Xanthogranulomatous cholecystitis (XGC) is a rare, destructive inflammatory gallbladder disease.
- XGC can present with symptoms and imaging findings that closely resemble gallbladder carcinoma.
Observation:
- A 35-year-old male presented with right upper quadrant pain and jaundice.
- Imaging revealed gallbladder wall thickening, and intraoperative findings suggested malignancy.
- Despite suspicious findings, pathological examination confirmed XGC, not cancer.
Findings:
- Preoperative and intraoperative differentiation between XGC and gallbladder cancer is challenging.
- Inflammatory involvement of surrounding tissues can further complicate the diagnosis.
- Coexistence of XGC and gallbladder carcinoma is possible.
Implications:
- Radical surgical resection is warranted when malignancy cannot be definitively excluded.
- Accurate pathological diagnosis is crucial for determining the correct treatment strategy.
- Awareness of XGC's mimicry is vital for surgical and pathology teams.
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