Gallbladder and cystic duct paraganglioma equiring cystic duct Re-excision

Gallbladder paragangliomas are exceedingly rare neuroendocrine tumours, with fewer than 40 reported cases in the English literature. Paraganglioma of the cystic duct is even rarer, with only one prior case documented. We report the case of a male in his late 40s who presented with recurrent, intermittent abdominal pain and was diagnosed preoperatively with cholelithiasis. He underwent an elective laparoscopic cholecystectomy, after which postoperative histopathology revealed an incidental gallbladder paraganglioma with positive margins at the cystic duct. A metastatic work-up was negative, and the patient subsequently underwent laparoscopic re-excision of the cystic duct stump and regional lymphadenectomy. Histology confirmed residual tumour with negative margins and no nodal metastasis. The patient remains under short-term follow-up. This case underscores the diagnostic and therapeutic challenges of incidental gallbladder paraganglioma, particularly when surgical margins are involved, and highlights the need for individualised management in the absence of formal guidelines.