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Diffuse Xanthogranulomatous Cholecystitis: Master of Disguise
Vladimir Neychev1, Vesela Ivanova2, Tihomir Dikov2
1Department of Clinical Sciences, University of Central Florida College of Medicine, Orlando, USA.
Cureus
|June 21, 2018
Summary
Xanthogranulomatous cholecystitis (XG) can mimic advanced gallbladder cancer (CG) on initial evaluation. Final pathology revealed XG, not CG, highlighting the diagnostic challenge of this rare condition.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Oncology
Background:
- Advanced gallbladder cancer (CG) presents with poor prognosis.
- Mass-forming xanthogranulomatous cholecystitis (XG) shares clinical and imaging similarities with CG.
Observation:
- A 67-year-old woman initially suspected of advanced CG underwent extended cholecystectomy.
- Pathology revealed diffuse XG with ruptured Rokitansky-Aschoff sinuses and adenomyosis, not malignancy.
- Adjacent liver and lymph nodes showed reactive inflammatory changes.
Findings:
- Definitive diagnosis of XG was delayed until final pathology.
- Preoperative and intraoperative findings can be misleading, resembling advanced CG.
- XG is a benign condition that can be misdiagnosed as malignant.
Implications:
- Misdiagnosis of XG as CG can lead to inappropriate treatment and patient distress.
- Increased awareness of XG is crucial for accurate diagnosis and management.
- Further understanding of XG's biology and natural history may improve patient outcomes.
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