A rare gallbladder ciliated foregut cyst in chronic cholecystitis

Area of Science:

• Gastroenterology
• Surgical Pathology
• Embryology

Background:

• Ciliated foregut cysts (CFCs) are rare congenital anomalies originating from foregut remnants.
• Typically found above the diaphragm, they can also occur in relation to abdominal organs like the gallbladder.
• Characterized by ciliated pseudostratified columnar epithelium, CFCs can mimic neoplastic conditions.

Purpose of the Study:

• To report the first case of a ciliated foregut cyst of the gallbladder in Australia.
• To highlight the rarity and diagnostic challenges of gallbladder CFCs.
• To emphasize the importance of surgical management for these cysts.

Main Methods:

• A 61-year-old male with chronic cholecystitis underwent laparoscopic cholecystectomy.
• Intraoperative findings noted an unusual 'out-pouching' on the gallbladder.
• Histopathological examination confirmed the cyst lining with ciliated columnar epithelium.

Main Results:

• This represents the ninth reported case of a gallbladder CFC globally and the first in Australia.
• The patient was an older male, contrasting with most previously reported younger female cases.
• Histology confirmed the characteristic ciliated columnar epithelium of a CFC.

Conclusions:

• Gallbladder CFCs are rare, with only 8 prior reports worldwide.
• These cysts can be difficult to distinguish from malignancies, necessitating awareness.
• Surgical excision is recommended to prevent potential dysplasia and malignancy.