Tuberculosis or Gallbladder carcinoma? A confusing presentation in an endemic region

Gallbladder tuberculosis (GT) is an extremely rare clinical entity that represents only 1 % of abdominal tuberculosis cases. Preoperatively, most patients are misdiagnosed as chronic cholecystitis or gallbladder malignancy.

We report the case of a 43-year-old patient, whose clinic, imaging and biology were in favor of Gallbladder carcinoma.

The clinical presentation of GT is varied and nonspecific, making the preoperative diagnosis of GT difficult; it may mimic acute cholecystitis to frank malignancy as seen in our case. Preoperatively, GT poses a diagnostic dilemma despite advanced imaging modalities, leading to missed diagnosis. The biology remains non-specific also. The diagnosis is usually made upon histological examination after cholecystectomy.

Even though the clinical presentation and the radiology are aspecific and misleading, It seems to us justified to evoke the diagnosis of tuberculosis faced with such a presentation, especially if the patient comes from a tuberculosis-endemic country. Diagnosis is made upon histopathological examination.