Paraganglion, a pitfall in diagnosis after regular cholecystectomy

Area of Science:

• Gastroenterology
• Surgical Pathology
• Oncology

Background:

• Neuroendocrine neoplasms (NENs) of the gallbladder are exceptionally rare.
• Distinguishing between NENs and benign structures is critical for appropriate patient management.

Purpose of the Study:

• To report a case of a benign gallbladder paraganglion misdiagnosed as a neuroendocrine tumor (NET).
• To emphasize the histopathological mimicry between gallbladder paraganglia and NENs.

Main Methods:

• A 27-year-old female underwent laparoscopic cholecystectomy for symptomatic gallstones.
• Initial histopathology suggested a NET; however, expert revision revealed a benign paraganglion.

Main Results:

• The revised histopathology confirmed the presence of a normal gallbladder paraganglion, not a neuroendocrine tumor.
• Gallbladder paraganglia are rare findings during routine histopathological examination.

Conclusions:

• Neuroendocrine neoplasms of the gallbladder require tailored treatment, ranging from surgery to chemotherapy for metastatic disease.
• Benign gallbladder paraganglia do not necessitate further treatment beyond initial diagnosis.
• Awareness of paraganglion mimicry is crucial for clinicians to prevent overtreatment of suspected gallbladder NENs.