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Gallbladder adenomyomatosis revisited - Does size matter? is follow-up required for large lesions?
Shirley Shechter1, Dana Ben-Ami Shor1, Roie Tzadok1
1Department of Radiology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 6423906, Israel; Department of Diagnostic Imaging, Faculty of Medical & Health Sciences, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel; Department of Gastroenterology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 6423906, Israel; Department of Gastroenterology, Faculty of Medical & Health Sciences, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel.
Objectives:
Adenomyomatosis (ADM) is generally considered a benign condition. However, it can be associated with chronic cholecystitis - a known risk factor for gallbladder cancer. Therefore, studies have proposed follow-up with ultrasound for asymptomatic patients with focal ADM. Currently, there are no formal recommendations regarding the frequency and length of follow-up. The aims of this study were to assess the growth of ADM lesions during follow-up and to examine the differences between larger and smaller ADM lesions.
Methods:
144 patients who underwent MRI-MRCP at our institution between the years 2014-2024 were identified through radiological reports as having a diagnosis of ADM. 43 patients had more than one examination. Demographic, clinical and radiological data were collected retrospectively. We divided the cohort into two groups based on the primary lesion size (axial diameter below or above 1.5 cm) and compared between them.
Results:
The group of small lesions included 98 patients and the larger lesions group included 46 patients. We did not find a statistically significant correlation between the size of. ADM and the demographic or clinical characteristics examined. Only 9 ADM lesions grew during follow-up - 6 from the smaller lesions group and 3 from the large lesions group (p > 0.05). The median follow-up period was 35 months. None of our patients developed gallbladder carcinoma.
Conclusions:
Our results confirm the common hypothesis that ADM are benign lesions. Therefore, we believe that follow-up is not needed for lesions with a clear diagnosis of focal ADM.
