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Intraoperative Strategy under Complex Vascular Adhesion for Laparoscopic Radical Resection of Bismuth-Corlette Type IIIb Perihilar Cholangiocarcinoma
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Delayed phlegmon with gallstone fragments masquerading as soft tissue sarcoma.

Laura F Goodman1, Cyrus P Bateni2, John W Bishop3

  • 1Division of Surgical Oncology, UC Davis School of Medicine, Sacramento, CA, USA.

Journal of Surgical Case Reports
|June 24, 2016
PubMed
Summary

Lost gallstones after gallbladder removal are rare but can mimic cancer. This case highlights retained gallstones presenting as a soft tissue tumor, emphasizing accurate diagnosis for proper patient care.

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Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Oncology

Background:

  • Complications from lost gallstones post-cholecystectomy are uncommon but can manifest across various organ systems.
  • Malignant presentations of retained gallstones are infrequently reported in medical literature.

Observation:

  • An 87-year-old woman developed a flank soft tissue tumor four years after laparoscopic cholecystectomy.
  • Initial assessments suggested soft tissue sarcoma (STS), necessitating further investigation.

Findings:

  • Multidisciplinary review identified retained gallstones as the cause of the soft tissue tumor, not STS.
  • The patient underwent incisional biopsy and drainage, with successful retrieval of gallstones.

Implications:

  • This case underscores the importance of considering retained gallstones in the differential diagnosis of soft tissue masses post-cholecystectomy.
  • Accurate diagnosis and multidisciplinary care are crucial for optimizing patient outcomes and avoiding unnecessary extensive surgeries.